单疱病毒性角膜炎细胞免疫研究

对病毒性角膜炎病人的细胞免疫机能报道较少，特别对红细胞免疫未见报道，本文对20例不同类型的单疤病毒性角膜炎病人进行了细胞免疫机能测定，与正常健康输血员组对照．免疫测定方法及材料．对单疱角膜炎治疗前均未用激素一类抑制免疫机能的药物，每例均进行免疫机能测定．（一）一般材料本组20人，女2例，男18例，均为单眼，最大年龄67岁，最小年龄15岁，点状疱疹性角膜炎9例．树枝状角膜炎2例，深层盘状基质型7例，地图状角膜溃疡型2例．（二）免疫测定方法：（1）红细胞C3b受体花环试验方法（上海长海医院郭峰法）（1）将洗过3次的待测…     

单疱病毒性角膜炎局部角膜免疫组化研究

目的 观察单纯疱疹病毒性角膜炎局部角膜免疫反应与其发 关系。方法 用ＨＥ染色及ＬＳＡＢ法染色对２１例ＨＳＫ病例角膜两全是及免疫组化观察。结果 组织病理显示ＨＳＫ活动期以多形核白细胞为主，少量单核样细胞。静止期以单核样细胞为主。免疫组化显示ＣＤ４、ＣＤ８、ＣＤ１４、ＣＤ１５、ＣＤ２０、ＣＤ６８、ＣＤ７１、ＨＬＡ－ＤＲ、ＨＳＶ－１、ＨＳＶ－２阳性率分别为１５．８％、１５．８％、４７．１％、２１．１％、     

复发单疱病毒性角膜炎与HLA抗原

我们对复发单疱病毒性角膜炎(HSK)病人HLA—A、B 抗原进行检测。结果显示HLA—B_5抗原频率有增加的趋势(P<0.05),但校正P 值无显著意义(P>0.05),提示HLA—B_5抗原可能是发生复发HSK的一种易感因素。     

中西医结合治疗单疱病毒性角膜炎

自1990年以来，我们采用中西医结合治疗”单症病毒性角膜炎“（简称Hsk）病人30例30只眼，效果满意．报告如下：临床资料本文统计门诊单疱病毒性角膜炎（Hsk）病人30例．其中男19例，女11例，年龄9－65岁．初发21例，复发9例，均为单眼，其中2例反复发作达5次．浅层型13例（角膜上皮病变或浅层基质病损），深层型17例（角膜后2／3厚度病损，溃疡，合并葡萄膜炎）．治疗方法一．炎症浸润期刺激症状重：眼痛，畏光，流泪，视物模糊，眼球混合充血，角膜浸润重．治则：流风清热，泄肝退翳方剂：菊花12g连翘12g．荆芥10g防风10g大青叶15g．黄苓…     

实质型单疱病毒性角膜炎的联合用药治疗

用无环鸟苷、消炎病和左旋咪唑联合用药治疗实质型单疱病毒性角膜炎４３例４５眼，全部治愈。观察２至３年无一例复发，并对疗效机理作了讨论。     

单疱角膜炎患者外周血白细胞介素Ⅱ活性与自然杀伤细胞活性的关系

目的了解单疱角膜炎（ＨＳＫ）患者的细胞免疫功能状态，从免疫学角度探讨ＨＳＫ的发病与复发机制。方法检测４０例正常人，２８例活动期ＨＳＫ（上皮型１３例、基质型１５例），２１例非活动期ＨＳＫ的外周血淋巴细胞白细胞介素Ⅱ（ＩＬ－２）活性及自然杀伤细胞（ＮＫ）活性水平。结果ＨＳＫ患者的ＩＬ－２及ＮＫ活性明显低于正常人，二者呈正相关关系，且基质型ＨＳＫ的变化显著。结论在ＨＳＫ的发生与发展过程中有免疫机制的参与，表现为细胞免疫功能低下。     

单疱病毒性角膜炎患者外周血T淋巴细胞体外活化的研究

目的:了解单疱病毒性角膜炎(herpes simplex keratitis,HSK)患者外周血T细胞体外活化的能力。方法:应用流式细胞技术对7例HSK基质型患者及4例溃疡型患者外周血、外周血体外培养、外周血与植物凝集素(phytohemagglutinin,PHA),沸波醇酯(phorboll2,13-dibutyrate PDB)及PDB加钙离子导入剂(ionophore,IONO)体外培养后T细胞表面HLA-DR、CD25、CD69、CD71的表达进行检测,并与6例正常人进行对照。结果:HSK基质炎型患者外周血CD3~ DR~ 细胞高于正常组,CD3~ CD71~ 细胞低于正常组。外周血培养72小时后,HSK基质炎型组CD8~ CD71~ 低于正常组,溃疡型CD8~ CR~ 、CD8~ CD69~ 、CD8~ CD71~ 低于正常组,CD8~ DR~ 也低于基质炎型组。外周血加PHA培养72小时后,HSK基质炎型及溃疡型组CD3~ CD71~ 、CD8~ CD69、CD8~ CD71均低于正常组,溃疡型组CD8~ CD25~ 也低于正常组,CD8~ CD69~ 低于基质炎型组。HSK基质炎型组在外周血加PDB培养组的CD3~ CD71~ 及在外周血加PDB及IONO培养的CD3~ CD69~ 均低于正常组。结论:HSK患者外周血T细胞的体外活化能力明显降低,HSK溃疡型患者的外周血T细胞的活化能力较HSK基质型更差。眼科学报1999;15:225-228。     

单纯疱疹病毒性角膜炎角膜组织病毒潜伏感染的PCR检测分析

 目的  探讨通过穿透性角膜移植获取的单纯疱疹病毒性角膜炎病变角膜组织中1型单纯疱疹病毒（HSV-1）DNA的表达情况及意义。设计 实验研究。研究对象  2010年5-12月北京同仁医院因病毒性角膜炎角膜白斑行穿透性角膜移植术后角膜标本20例,圆锥角膜、大泡性角膜病变和角膜营养不良等非感染性角膜病变的角膜标本20例。方法  对角膜组织标本中HSV-1 DNA进行聚合酶链反应（PCR）检测。 主要指标  HSV-1 DNA的阳性率。结果  单纯疱疹病毒性角膜炎静止期患者角膜组织中12/20例（60%）检出HSV-1 DNA,非感染性角膜组织中6/20例（30%）检出HSV-1 DNA（χ2=3.64,P=0.057）。结论  单纯疱疹病毒性角膜炎静止期角膜组织多数表达HSV-1 DNA,角膜内潜伏病毒是引起单纯疱疹病毒性角膜炎的可能原因,正常人角膜也可能有HSV-1的DNA存在。（眼科,2013,22：45-48）     

Delayed Type Hypersensitivity in the Pathogenesis of Recurrent Herpes Stromal Keratitis

Recurrent herpes stromal keratitis (HSK) is one of the leading causes of blindness in the developed world. Cyokines characteristic of Th1 cells (in particular IFN-γ and IL-2) have been shown to dominate in HSK in addition to mechanisms by nonspecific, antigen-independent effector cells such as neutrophils, basophils, and monocytes. More recently, the migration and maturation of dendritic cells (DC) within the corneal stroma of patients with HSK have been recognized as contributors to recurrent disease, suggesting a role for delayed type hypersensitivity (DTH) in the immunopathogenesis of HSK. The role of DC and DTH in recurrent HSK has not been studied extensively and experimental models of recurrent HSK focusing on DTH as the pathogenesis and viral particles as the triggering antigen may contribute to better understanding of the disease.     

CBSC结膜下注射对HSK患者血T-LC亚群IL-2及SIL-2R水平的影响

目的探讨脐血干细胞结膜下注射对单纯疱疹性角膜炎(herpes simplex keratitis,HSK)患者血T淋巴细胞(TLC)亚群、白细胞介素-2(IL-2)及可溶性IL-2受体(SIL-2R)水平含量的影响,并观察其临床疗效程度.方法将患者随机分为2组,治疗组50例51眼,以脐血干细胞(CBSC)结膜下注射治疗为主,共注射3次;对照组50例52眼,以干扰素(IF)结膜下注射治疗为主;2周后评价疗效,检测2组患者血T-LC亚群、IL-2及SIL-2R水平含量,并与50例健康者作正常对照.结果 2组患者治疗前血T-LC亚群CD4(39.7±6.6)%、CD8(29.6±5.4)%、CD4/CD8(1.34±0.61)及IL-2((1 658.2)±312.8)ng·L-1、SIL-2R(378.6±57.8U·mL-1)水平含量均明显不同于正常者(P<0.05);治疗后治疗组上述指标均明显较治疗前改善(P<0.05),基本接近正常者(P>0.05),而对照组治疗前后上述指标均无明显差异(P>0.05),仍与正常者有一定差异(P<0.05);2组治疗后上述指标间比较均有显著性差异(P<0.05);临床观察显示治疗组疗效明显优于对照组(P<0.05),且平均痊愈时间缩短(P<0.01)、复发率降低(P<0.05).结论脐血干细胞结膜下注射治疗HSK疗效可靠,且有明显调节患者血T-LC亚群、IL-2及SIL-2R水平作用.     

Cell culture isolation can miss the laboratory diagnosis of HSV ocular infection

AIM: We compared polymerase chain reaction (PCR) to cell culture isolation for the laboratory diagnosis of ocular herpes simplex virus (HSV) disease. METHODS: Laboratory and medical records of consecutive patients were reviewed for results of 1) HSV PCR testing, 2) HSV cell culture isolation, and 3) clinical diagnosis. PCR results were statistically compared to cell culture isolation and patients initially diagnosed for ocular HSV infection. RESULTS: Of 581 cases submitted for laboratory testing, 520 were PCR negative, cell culture negative (89.6%); 0 were PCR negative, cell culture positive (0%); 27 were PCR positive, cell culture negative (4.6%); and 34 were PCR positive, cell culture positive (5.8%). PCR tested more positive than cell culture isolation (McNemar's,P=0.0001). Of 47 HSV PCR positive cases with complete medical records, 19 were cell culture negative for HSV and 28 were cell culture positive for HSV. Fourteen of 19 cell culture negative cases (74%) (Without PCR, 5 cases of HSV would be missed) and 25 of the 28 cell culture positive cases (89%) (Laboratory testing was necessary for diagnosing 3 cases) were clinically diagnosed with HSV at the initial examination. CONCLUSION: PCR was a more definitive test for diagnosing HSV ocular infection than cell culture isolation. Cell culture isolation alone can miss an atypical presentation of HSV ocular infection.     

细胞分离培养在实验室诊断眼部单纯疱疹病毒感染疾病的误诊和漏诊情况

目的:对比聚合酶链反应(PCR)和细胞分离培养在实验室诊断眼部单纯疱疹病毒(HSV)感染疾病的作用。方法:我们对连续患者的实验室结果(PCR实验,细胞分离培养及临床诊断)及病历进行回顾性研究在诊断眼部HSV感染疾病过程中,PCR检测结果、细胞分离培养及首诊结果进行了统计比较。结果:患者581例经过检查后,520例PCR检查阴性,细胞培养阴性(89.6%);0例PCR检查阴性,细胞培养阳性(0%);27例PCR检查阳性,细胞培养阴性(4.6%);34例PCR检查阳性,细胞培养阳性(5.8%)。PCR检测阳性率高于细胞分离培养(McNemars,P=0.0001)。47例PCR检查为HSV初诊感染阳性患者中,19例患者中有14例为细胞培养阴性结果(74%),5例HSV患者因缺PCR检测结果将被误诊;28例患者中有25例患者细胞培养阳性(占89%),3例HSV患者因缺PCR检测结果将被漏诊。结论:PCR诊断眼部HSV感染优于细胞分离培养。细胞分离培养对于眼部HSV感染的非典型表现不易诊断。     

单疱性角膜炎患者外周血自然杀伤细胞活性的研究

观察４０例健康人，２８例活动期单疱性角膜炎（ＨＳＫ）患者（上皮型１３例、基质型１５例）、２１例非活动期患者的外周血自然杀伤细胞（ＮＫ）活性。结果表明：非活动期患者与正常人比较无显著差异，活动期患者与正常人和非活动期患者相比均有显著差异。不同类型其ＮＫ活性的改变不尽相同。并对其临床意义及复发机制进行初步探讨。     

Bilateral Limbal Stem Cell Alterations in Patients With Unilateral Herpes Simplex Keratitis and Herpes Zoster Ophthalmicus as Shown by In Vivo Confocal Microscopy

PurposeThe purpose of this study was to investigate the limbal changes in the palisades of Vogt (POV) in patients with herpes simplex keratitis (HSK) and herpes zoster ophthalmicus (HZO) with the application of in vivo confocal microscopy (IVCM).MethodsWe enrolled 35 eyes of 35 consecutive patients with HSK and 4 patients with HZO in this observational study. Thirty-five participants were also recruited from a healthy population as the control group. All subjects were examined by IVCM in addition to routine slit-lamp biomicroscopy. The IVCM images of the corneal basal epithelial cells, corneal nerve, and the corneoscleral limbus were acquired and then were analyzed semiquantitatively.ResultsThe rate of absent and atypical POV was significantly higher in the affected eyes of patients with HSK than in the contralateral eyes and eyes of controls (88.57% vs. 65.71% vs. 17.14%, P < 0.01). In the HZO group, the rate of absent and atypical POV was 100% in the affected eyes and 50% in the contralateral eyes. When compared to the contralateral unaffected eyes and control eyes, the average density of the central basal epithelial cells and the sub-basal nerve plexus density and the total number of nerves in the central area of the affected eyes were significantly lower in the HSK group (1541 ± 704.4 vs. 2510 ± 746.8 vs. 3650 ± 746.1 cells/mm², P < 0.0001). Spearman''s rank correlation showed that the presence of absent and atypical POV had a significant negative correlation with central corneal basal epithelial cells (r_s = −0.44979, P < 0.0001), the density of total nerves (r_s = −0.49742, P < 0.0001), and the total nerve numbers (r_s = −0.48437, P < 0.0001). A significant positive correlation was established between the presence of absent and atypical POV and HSK severity in affected eyes in the superior, inferior, nasal, and temporal quadrants (r_s = 0.68940, r_s = 0.78715, r_s = 0.65591, and r_s = 0.75481, respectively, P < 0.0001) and the contralateral eyes (r_s = 0.51636, r_s = 0.36207, r_s = 0.36990, r_s = 0.51241, correspondingly, P < 0.0001).ConclusionsBoth eyes of patients with unilateral HSK and HZO demonstrated a profound and significant loss of limbal stem cells, which may explain the fact that HSK and HZO are risk factors for limbal stem cell deficiency (LSCD) in both eyes. The loss of LSCs was strongly correlated with the sub-basal nerve plexus and central basal epithelial cell alterations as shown by IVCM.     

单纯疱疹病毒性角膜炎中细胞凋亡的作用机制研究进展

单纯疱疹病毒性角膜炎（HSK）是一种严重的世界性致盲性角膜疾病,发病机制目前尚不明确。近年来的研究表明,该病的发病机制与细胞凋亡密切相关。病毒感染角膜后,可诱导角膜上皮细胞发生凋亡,随后抑制凋亡过程。同时亦可引起浅层基质发生细胞凋亡,以防止病毒从感染的上皮细胞传染至角膜深部。而当病变累及角膜深层时,常可发生角膜基质混浊、坏死、瘢痕形成、新生血管化以及角膜内皮皱褶等。就HSK发病过程中角膜上皮、基质、内皮发生细胞凋亡的机制进行综述。