Analysis and validation of hub genes and immune cell infiltration characteristics in lens epithelium tissue with cataract surgical history

Purpose This study aims to employ transcriptomic analysis to investigate the characteristics of immune cell infiltration during Posterior capsular opacification (PCO) following cataract surgery, identify hub genes, elucidate the associated molecular pathways, and explore the potential interventional role of Cyclosporine A (CsA) in this process. Methods Data from lens capsules of non-cataract donors and those with cataract surgery history were obtained from the GEO database. Hub genes were identified through a systematic bioinformatic approach. The final hub genes were validated internally and with external datasets. Their correlations with immune profiles were assessed via CIBERSORT, and pathway enrichment analysis was conducted for immune-related genes. Cellular experiments simulated pathological conditions to validate hub gene expression, and molecular docking evaluated the binding affinity of CsA to the encoded proteins. Results Hub genes (FN1, SERPINE1, THBS1) were identified and validated. Their expression was associated with significant alterations in immune cell infiltration (resting CD4 + memory T cells, M0 macrophages, CD8 + T cells), which correlated with the genes and PCO-related pathways. CsA exhibited favorable binding affinity to proteins encoded by FN1 and SERPINE1. Conclusions Hub genes demonstrated strong discriminatory power in the gene expression profiles of lens capsules with a history of cataract surgery, occupying central positions within the co-expression network. Alterations in immune cell infiltration, closely linked to these hub genes, are significantly associated with pathways involved in PCO. CsA may inhibit PCO by targeting the proteins encoded by these hub genes and through its immunomodulatory functions.