NF-κB在眼科领域的研究进展

核转录因子κB(nuclear factor-kappa B,NF-κB)是一种几乎存在于所有细胞中具有多向、多效调控作用的核转录因子。它可参与调控细胞的增生、分化、黏附、凋亡、炎症反应和免疫应答等生理病理过程,在机体的生长发育、炎症反应、免疫应答和肿瘤生长等方面发挥重要的作用。近些年的研究表明,NF-κB在眼科相关疾病的发病机制中占有重要的地位,尤其是眼表疾病、白内障、青光眼、葡萄膜炎、眼底疾病等,针对NF-κB活化的抑制可能成为眼科疾病治疗的新型靶点。本文将对NF-κB在眼科领域的研究报道进行综述。     

TSG-6在眼科疾病中的研究进展

肿瘤坏死因子α刺激基因-6(tumor necrosis factor α stimulated gene 6,TSG-6)编码的分泌性蛋白是一种保护性的炎症反应因子,它通过与透明质酸、硫酸软骨素或蛋白多糖结合,介导炎症细胞迁移、黏附,参与免疫调节和细胞外基质重塑,进而发挥炎症调控作用.重组TSG-6蛋白已应用于多种疾病模型的研究,并表现出了广泛而强烈的抗炎作用.最近的研究发现,重组人TSG-6局部应用可减轻多种眼病的炎症反应和病理表现.近几年间充质干细胞在眼科疾病的研究和应用取得了突破性的进展,而TSG-6已被证明是间充质干细胞发挥作用的关键媒介.这提示TSG-6很可能成为眼病治疗的新靶点,有潜在的临床应用价值.     

泪液标志物在系统性疾病中的研究进展

泪液是主要由泪腺分泌的一种水样液体,是眼表的一种成分复杂的体液,可能含有数千种蛋白质及其他分子,研究已证实这些成分的改变在眼病的发生和发展中具有重要作用.泪液成分包括蛋白质、脂质及代谢物等,容易获取,不仅可以用于生物标志物,还可用于研究眼科系统性疾病的发病过程.通过测定泪液成分的变化,可能用来确定疾病发展的关键通路,为预防及治疗提供了一种新的可能.本文将到目前为止尚未确定的泪液标志物在眼科系统性疾病的应用做一简要综述.     

瘦素与眼科疾病

瘦素是脂肪细胞分泌的一种肽类激素,可影响机体能量平衡,起到调节神经内分泌功能的作用.作为一种细胞因子,瘦素可影响促炎症细胞因子的产生,促血管生成和细胞增殖,还可调节炎症和免疫反应.本文就瘦素与眼科疾病如眼表疾病、视网膜疾病和眼眶病等的关系作一综述.     

可注射水凝胶治疗眼科疾病的研究进展

眼部结构的特殊性使眼科疾病的治疗面临很多阻碍。水凝胶作为一种具备多维应用潜能的高分子材料,有着可控的力学性能及生物性能,是组织工程、生物工程等领域的研究热点。水凝胶良好的透明性、安全性、兼容性也提示了水凝胶在眼科领域广阔的研究前景。目前已应用于眼科的水凝胶有人工泪液、药物载体、黏附剂等。本综述介绍了可注射水凝胶在制作、性能及应用方面的特点,概述了可注射水凝胶作为药物载体、组织黏附剂、空间填充剂以及细胞载体在眼科疾病中的应用进展及挑战,特别介绍了可注射水凝胶近年来在角膜外伤、青光眼、白内障、视网膜脱离及年龄相关性黄斑变性等疾病治疗方面的研究。     

骨桥蛋白与眼部疾病的研究进展

骨桥蛋白是一种酸性磷酸化糖蛋白,含有与细胞粘附和侵袭相关的精氨酸.甘氨酸一天冬氨酸序列.作为一种细胞外基质,可以与整合素受体和黏附分子CD44受体特异性结合,与炎症、血管形成、免疫疾病、肿瘤的发生、发展和转移有密切联系.近年来,对骨桥蛋白在眼病中的研究正逐渐成为热点.本文就骨桥蛋白与眼病关系的研究进展做一概述.     

B7:CD28/CTLA-4共刺激分子及其在眼科的研究进展

大量实验证实B7家族分子与其受体CD2 8和CTLA 4结合后所产生的共刺激信号在T淋巴细胞激活中起重要作用 ,决定着受到抗原刺激的T细胞是分化、增殖为效应细胞 ,还是进入无反应状态。其在眼科的研究主要集中于眼科自身免疫性疾病、角膜和视网膜三个方面 ,阻断B7:CD2 8/CTLA 4通路可能为眼科自身免疫性疾病、角膜移植排斥反应和视网膜葡萄膜疾病的治疗提供新的途径。本文就其分子特性、功能及其在眼科的研究进展等方面的有关资料作一综述。     

Netrin-1在眼病中的研究进展

Netrin-1是神经轴突的导向因子,为一种由细胞底板分泌的可溶性蛋白,属于Netrins家族中研究最为广泛的一员。Netrin-1具有受体多样性,其与不同的受体结合可以激活不同的生物学效应,从而发挥多种功能。近年来研究发现,Netrin-1与神经轴突导向、炎症反应、新生血管形成、细胞凋亡等反应密切相关,不仅可在中枢神经系统发挥作用,还与许多系统疾病如呼吸道系统、心血管系统等疾病有关,使其成为治疗这些疾病的重要靶点。在眼科领域,Netrin-1与视神经发育不全(ONH)、角膜疾病、糖尿病视网膜病变(DR)、年龄相关性黄斑变性(ARMD)、视网膜母细胞瘤(RB)等疾病紧密联系,且在预防及治疗这些疾病中具有非常广阔的应用前景。在本篇综述中,我们将探讨Netrin-1与眼科疾病的联系及其作用。     

环状非编码RNA在眼部疾病中表达研究进展

环状非编码RNA（circRNA）是指一类不具有5’末端帽子和3’末端poly（A）尾巴的一类非编码RNA,其通过共价键形成环形结构,它们可以通过几种不同的机制调节蛋白质的编码。越来越多的研究发现,circRNA在细胞增殖、分化、凋亡、血管生成、免疫调节等多种细胞功能中发挥一定的作用,从而导致多种疾病（如恶性肿瘤、炎症性疾病、神经系统疾病等）的发生。本文综述了circRNA在眼科疾病中的潜在作用和可能机制,以期能够为相关眼科疾病的早期诊断和不同阶段的治疗提供新的思路。     

B7：CD28／CTLA—4共刺激分子及其在眼科的研究进展

大量实验证实B7家族分子与其受体CD28和CTLA-4结合后所产生的共刺激信号在T淋巴细胞激活中起重要作用,决定着受到抗原刺激的T细胞是分化、增殖为效应细胞,还是进入无反应状态,其在眼科的研究主要集中于眼科自身免疫性疾病、角膜和视网膜三个方面,阻断B7：CD28/CTLA-4态。其在眼科的研究主要集中于眼科自身免疫性疾病、角膜和视网膜三个方面,阻断B7：CD28/CTLA-4通路可能为眼科自身免疫性疾病、角膜移植排斥反应和视网膜葡萄膜疾病的治疗提供新的途径,本就其分子特性、功能及其在眼科的研究进展等方面的有关资料作一综述。     

Follow-up studies in pattern VECP in demyelinating diseases in children

Spectral sensitivity functions and the transient decrease of sensitivity to short wavelengths after the offset of yellow light (transient tritanopia) were measured by increment threshold techniques in patients suffering from hereditary macular degenerations. Color vision defects were determined by arrangement tests and the anomaloscope. Central areolar choroidal dystrophy was found to produce a mild protan defect and to reduce foveal spectral sensitivity throughout the visible spectrum by a factor of 100; it also abolishes transient tritanopia. Electroretinogram (ERG) was normal, electrooculogram (EOG) subnormal. Stargardt's disease, despite numerous fluorescent macular spots, does not abolish transient tritanopia nor does it reduce spectral sensitivity, although scotopic matches were performed on the Nagel anomaloscope. Only in severe, advanced cases was transient tritanopia reduced and spectral sensitivity found to follow the absorption spectrum of rods. Routine ERGs and EOGs were normal. Vitelliform macular degeneration, despite the ophthalmoscopically pronounced dystrophic macula, produced only very small changes in spectral sensitivity and transient tritanopia, although a widened matching range on the Nagel anomaloscope and electrophysiological abnormalities were found. Apparently damage of the retinal circuit which connects long and short wavelength-sensitive cones, caused by hereditary conditions, is different from that caused by retinotoxic drugs.     

p53 expression in pterygium in two climatic regions in Turkey

Purpose:

To assess accumulation of p53 protein in samples of primary pterygium from people living in two different climatic regions in Turkey.

Materials and Methods:

Group 1 included 101 pterygium specimens from people in Adana located in southern Turkey. Group 2 included 39 pterygium specimens from people in Ankara, located in the middle of Turkey. Climatic conditions throughout the year are sunnier and warmer in Adana than they are in Ankara. The control group (Group 3) included 30 specimens of conjunctiva that had been excised during cataract surgery from 30 patients without pterygium. The pterygial specimens and control conjunctiva were studied by immunohistochemistry using antibodies against p53 protein. Pearson''s chi-square test was used to compare the p53 immunoreactivity.

Results:

The p53 immunoreactivity in Groups 1 and 2 was greater than it was in the control group (P<0.001). There were no differences in p53 immunoreactivity between Groups 1 and 2 (P= 0.060).

Conclusion:

The p53 immunoreactivity was not correlated with ultraviolet irradiation exposure. The p53 immunoreactivity in our pterygium specimens suggests that pterygium could be a result of uncontrolled cell proliferation.     

Changes in Bruch's membrane in experimental hypercholesteremia in rats

PURPOSE: We investigated the effect of high cholesterol diet for the aging changes in Bruch's membrane of rats. METHODS: After feeding a 4% cholesterol diet for 15 weeks to three young rats 3 months old and four aged rats 23 months old, we observed the morphological changes of Bruch's membrane by electron microscopy, and made a comparison with rats fed an ordinary diet. RESULTS: In one young rat fed a high-cholesterol diet, the endothelial basement membrane of the choriocapillaris formed multiple folds separated from the plasma membrane of the endothelium and showed lamellar thickening and crack in some areas. The elastic fiber layer in Bruch's membrane disappeared partly and some new microfibrils appeared. In one aged rat fed a high-cholesterol diet, the endothelial basement membrane of the choriocapillaris showed more lamellar thickening with lumps in some parts. Compared with rats fed an ordinary diet, rats fed a high-cholesterol diet showed thickening of the basement membrane and the changes were more severe. CONCLUSIONS: Our data indicated that high-cholesterol diet might promote age-related changes of Bruch's membrane.     

Trends in Patterns of Anterior Uveitis in a Tertiary Institution in Singapore

Purpose: To report the trends in etiology of patients with anterior uveitis (AU) in Singapore over 6 years.

Methods: A retrospective review of the clinical records of all new patients who presented with anterior uveitis to the uveitis subspecialty clinic from 2005 to 2010 at Tan Tock Seng Hospital, Singapore.

Results: There were 552 new cases of AU. This comprised 59.5% of a total of 928 new patients diagnosed with uveitis from 2005 to 2010. The mean age was 48.0?±?17.2 years. There was a male predominance (62.5%), with a male:female ratio of 1.7:1. The majority were of Chinese ethnicity (69%), followed by Malays (13.2%). Most cases were unilateral (79.5%) and idiopathic (50.4%). Common etiological causes included Fuchs heterochromic iridocyclitis (FHI) (5.6%), ankylosing spondylitis (AS)-related AU (5.1%), herpes simplex virus (HSV) (4.7%), and herpes zoster virus (HZV) (4.5%). There were increasing trends in AS-related AU from 3.2% in 2008 to 6.5% in 2010, and psoriasis-associated AU from 1.7% in 2005 to 4.0% in 2008. There were decreasing trends in the incidence of FHI from 10.6% in 2006 to 4.7% in 2009. No change in incidence of viral etiologies was noted, but cytomegalovirus-related immune-recovery uveitis (IRU) comprised 7.4%. IRU showed an increasing trend from 1.7% in 2005 to 11.9% in 2007, then decreased to 3.3% in 2010. Using the Pearson chi-square test, there was no statistically significant association between ethnicities (Chinese, Malay, Indian) comparing infectious and noninfectious cases (p?=?0.788), idiopathic and nonidiopathic cases (p?=?0.170), or between the various etiologies of uveitis (p?=?0.168).

Conclusions: AU was the predominant form of uveitis seen at our centers. Infectious etiologies (18.5%) are the most common among nonidiopathic cases, with herpes viruses (9.2%) being most prevalent. Despite increased use of polymerase chain reaction (PCR) in the detection of microbial and viral DNA, there was no overall increase in detection of infectious causes for uveitis. The changes in CMV-related immune recovery uveitis from 2005 to 2010 could reflect a change in HIV management in Singapore.     

内毒素诱导的大鼠葡萄膜炎的巨噬细胞中Toll样受体4的表达

目的 探讨在内毒素诱导的Wistar大鼠葡萄膜炎中Toll样受体4(TLR4)阳性细胞与虹膜组织中巨噬细胞的动态变化和分布.方法 实验研究.Wistar大鼠50只,用随机数字法随机分为5组,每组10只,分别为正常对照(0 h)组、6 h组、12 h组、24 h组及48 h组.除0 h组外其余各组均足垫部注射霍乱弧菌内毒素200μg,注射后于裂隙灯显微镜下观察双眼前节炎症反应变化.按实验分组于0、6、12、24、48 h处死大鼠.取虹膜一睫状体及脉络膜组织.通过葡萄膜铺片免疫组织化学方法检测TLR4和巨噬细胞的标记CD163的表达.人工计数虹膜中TLR4~+与CD163~+的细胞并计算细胞密度,计算圆形和多形性的CD163~+细胞占所有CD163~+细胞的百分比.进一步采用免疫荧光双标记检测TLR4和CD163共表达的情况.通过单因素方差分析分别对大鼠虹膜内阳性细胞密度以及圆形、多形性CD163~+细胞的百分比进行统计学检验.结果 正常大鼠虹膜睫状体组织不表达TLR4.6 h组有2只大鼠虹膜内可见少量TLR4~+细胞,12～48 h组所有大鼠虹膜内TLR4~+细胞明显增多(F=167.2,P＜0.001),虹膜内TLR4~+细胞密度分别为(506.1±39.5)个/mm~2(12 h组)、(492.3±54.5)个/mm~2(24 h组)及(663.8±150.2)个/mm~2 (48 h组).在注射LPS后12～48 h期间TLR4~+细胞形态无明显变化.0～48 h组大鼠虹膜内均有CD163~+细胞,0 h组圆形和多形性CD163~+细胞百分比为13%,12～48 h组其百分比约为80%,且圆形细胞主要位于虹膜基质层.免疫荧光双标记可见TLR4和CD163的共表达,TLR4位于细胞膜,CD163位于细胞质.5组大鼠脉络膜内均未见TLR4表达.结论 内毒素诱导的大鼠葡萄膜炎中虹膜内TLR4表达增高,部分虹膜固有巨噬细胞表达TLR4.TLR4可能在葡萄膜炎的发生发展中起一定作用.     

Orthokeratology practice in children in a university clinic in Hong Kong*

Purposes: The aim of this study was to analyse clinical data of children undergoing orthokeratology (ortho‐k) and to investigate patients’/parents’ perspective on ortho‐k via telephone interviews. Methods: Clinical records of children undergoing ortho‐k from a university optometry clinic were reviewed and the effects of ortho‐k on refraction, vision and cornea were investigated. A telephone interview was conducted to solicit patients’/parents’ perspective of the treatment. Results: One hundred and eight files were reviewed. Median age of the children was nine years (range six to 15); mean (±SD) pre‐treatment refractive sphere was ‐3.56 ± 1.49 D and the median refractive cylinder was ‐0.50 D (range zero to ‐4.25 D). Significant refractive spherical reduction (58 per cent), improvement in unaided vision and corneal topographical changes were noted after only one night of wear. No significant change in astigmatism was found. Corneal staining was the most commonly observed complication with ortho‐k and more than 80 per cent of patients were advised to apply ocular lubricants to loosen the lens before lens removal. Ortho‐k was mainly undertaken for myopic control and about 90 per cent of the respondents reported good/very good unaided vision after ortho‐k and ranked the treatment as satisfactory or very good. Lens binding and ocular discharge were the most frequently reported problems during the treatment. Conclusion: Under close monitoring, overnight ortho‐k is effective and safe for reducing low to moderate myopia and the treatment is well accepted by the children.     

Advances in imaging in oculoplastics

Color Doppler imaging, computed tomography (CT) and magnetic resonance (MR) imaging are the most precious imaging tools for the clinician in the field of oculoplastics. Orbital and facial vasculature, with its dynamic changes and flow velocities seen in orbital varices, carotid-cavernous fistulas, and dural cavernous arteriovenous malformations, is best detected by Color Doppler imaging. Computed tomography remains the dominant imaging modality in the evaluation of orbital trauma. Helical CT axial scanning with multiplanar reconstruction and three-dimensional CT imaging are most helpful in assessing iatrogenic, traumatogenic, and teratogenic orbital abnormalities. Despite its poor histologic specificity, MR imaging provides superior soft tissue contrast, and contrast-enhanced MR imaging has an established role regarding soft tissue tumor infiltration. The greatest value of MR studies in the evaluation of orbital and palpebral tumors is that it has the capacity to show the precise relation between lesions and adjacent structures before the clinician contemplates a surgical approach. Finally, contrast-enhanced MR imaging proved to be a valuable vascularization indicator based upon the extent of relative enhancement within porous orbital implant in anophthalmic socket.     

弱视眼底光学相干断层扫描的研究进展

弱视是由于视觉发育关键期内各种异常的视觉经验导致单眼或双眼最佳矫正远视力低于正常同龄儿童,而眼部无明显器质性病变。目前普遍观点认为,弱视的发病机理主要源于视皮层。近年来,光学相干断层扫描（OCT）作为一种先进的活体成像技术,促进了对视网膜形态结构的大量研究,同时也被应用到弱视的研究领域。陆续有不同的研究人员利用OCT发现弱视患者眼底视网膜、脉络膜等眼部结构存在改变。笔者将对弱视眼底OCT的研究进展做一综述。     

年龄因素对成年人角膜厚度的影响

目的：探讨不同年龄段成年人角膜厚度的差异。方法：横断面研究。选择2015 年8-12 月就诊于青岛大学附属医院眼科的近视及白内障患者300 例（300 眼）。按年龄分为3 组：青年组96 例,平均年龄（26.4±5.5）岁;中年组86 例,平均年龄（62.1±6.8）岁;老年组118 例,平均年龄（79.2±5.6）岁。应用Galilei眼前房分析系统测量各组的角膜厚度。对各组中央角膜厚度（CCT）、旁中央角膜厚度（PaCT）、周边角膜厚度（PeCT）及角膜最薄点厚度（TCT）等指标进行比较分析。采用单因素方差分析、Kruskal-Wallis H秩和检验、Pearson相关分析及Spearman相关分析对数据进行分析。结果：3 组间CCT、PaCT差异均无统计学意义。PeCT总体差异有统计学意义（H =39.12,P < 0.001）,且青年组PeCT均比中年组和老年组PeCT厚（P < 0.05）。3组间TCT总体差异有统计学意义（H=31.63,P < 0.001）,且青年组TCT比中年组TCT厚（P =0.002）,中年组TCT比老年组TCT厚（P =0.002）。在各组内,中年组PeCT与年龄呈负相关（r =-0.288,P =0.007）,青年组、老年组的CCT、PaCT、PeCT、TCT与年龄均无相关性。对于总体,CCT、PaCT与年龄无相关性,而PeCT、TCT与年龄均呈负相关（r =-0.369、-0.343,P < 0.001）。结论：成年人的CCT、PaCT不随年龄的变化而改变,PeCT、TCT随年龄增长有变薄的趋势。