血管能抑素基因转移抑制视网膜新生血管的实验研究

目的 观察血管能抑素真核表达质粒(pCMV-HA)对小鼠视网膜新生血管RNV形成的抑制作用.方法 将鼠龄为7 d的56只C57BL/6J新生小鼠随机分为正常对照组、氧诱导视网膜病变(OIR)模型组、治疗组和空载体组,每组14只.后3组小鼠置于(75±2)%浓度的氧环境中饲养5 d后,回到正常空气环境中建立氧诱导的RNV动物模型.治疗组小鼠在出生后第12天出氧箱时行玻璃体腔注射血管能抑素pCMV-HA,空载体组注射等量空质粒.出生后第17天行伊凡思蓝(Evans blue)灌注血管造影视网膜铺片观察血管变化.石蜡切片行苏木精-伊红染色,光学显微镜下观察并计数突破视网膜内界膜的血管内皮细胞核数.结果 视网膜铺片结果显示,治疗组较OIR模型组和空载体组视网膜血管分布均匀,新生血管和无灌注区显著减少.治疗组突破内界膜的内皮细胞核数与OIR模型组及空载体组比较,差异有统计学意义(F=39.006,P<0.001).结论 血管能抑素pCMV-HA对氧诱导的RNV有显著的抑制作用.     

小鼠视网膜新生血管模型荧光素灌注造影

目的探讨使用一种具有较高相对分子质量的荧光素进行灌注造影,使小鼠视网膜新生血管模型眼底血管显影的可行性。方法向高氧诱导的视网膜新生血管模型小鼠心脏灌注具有较高相对分子质量的荧光素,眼球经过短暂固定后,通过显微手术镜游离视网膜并铺片,在荧光显微镜下观察视网膜血管的分布与形态。结果在荧光显微镜下清楚地观察到全视网膜血管形态、走行;通过调节焦点,使视网膜浅层、深层以及二者交通支都清晰显影。高氧诱导的视网膜新生血管主要发生在视网膜有血管区与无血管区的交界部位,可见渗出、出血、微血管瘤的表现。方法简便、快捷,重复性好。结论通过这种方法可以清晰、准确地动态了解视网膜新生血管模型小鼠眼底血管的病变部位及形态学改变。采用此种具有较高相对分子质量的荧光素进行灌注造影可以较好地应用于视网膜新生血管性疾病的基础研究。     

高氧诱导小鼠视网膜新生血管模型中端粒酶逆转录酶的表达变化

目的 研究高氧诱导视网膜新生血管模型中小鼠端粒酶逆转录酶(TERT)基因表达水平是否有变化,为进一步研究视网膜新生血管疾病的预防和治疗提供新的靶点.方法 实验研究.选取7 d龄C57BL/6J新生小鼠32只,分高氧组和对照组,每组16只.高氧组小鼠以密闭氧箱内以75%±2%氧浓度饲养5 d后置于正常氧浓度环境中,正常对照组小鼠于正常氧环境中饲养.于小鼠生后12、14及19 d时分别取高氧组和对照组小鼠各2只(4只眼),经尾静脉行2%伊文思蓝溶液灌注并做视网膜铺片,荧光显微镜下观察视网膜新生血管的形成情况.高氧模型组和正常对照组生后19 d幼鼠3只,行HE染色,光学显微镜下观察视网膜血管形态,观察突破内界膜的内皮细胞核数.取生后19 d高氧组和对照组小鼠,分别取其视网膜组织并提取总RNA,反转录成cDNA后行反转录PCR,2%琼脂糖凝胶电泳并照相.提取视网膜总RNA,反转录成cDNA后(同RT-PCR),配制荧光定量实时PCR反应体系(总计20μl),在60℃检测荧光信号,分析图像.分别取高氧模型组和正常对照组P19小鼠行眼球切片,常规处理后TERT抗体孵育37℃ 60 min,HRP酶标二抗孵育30 min,DAB显色,中性胶封片,镜下观察并照相.结果高氧诱导模型小鼠牛后12 d眼底后极部出现大片无灌注区,生后14 d眼底后极部出现新牛血管迂曲、渗漏等视网膜血管病变.生后17～19 d视网膜新生血管形成达到高峰.正常小鼠视网膜组织切片HE染色基本看不剑突出内界膜的血管芽及血管管腔,内界膜下视网膜内的血管内皮细胞核散在分布、数量较少;高氧组见大量突出内界膜伸向玻璃体腔的血管管腔及血管芽,内界膜下视网膜内也有大量血管内皮细胞增生.19 d高氧模型组小鼠视网膜TERT及bFGF mRNA表达较同日龄正常对照组小鼠明显提高,二者差异有统计学意义(F=8.575,5.667;P＜0.05).生后19 d实时PCR检测高氧模型组小鼠视网膜TERT mRNA表达较同日龄正常对照组小鼠明显上调,差异有统计学意义(F=173.104,P＜0.05).生后19 d高氧诱导小鼠视网膜新生血管模型中视网膜新生血管TERT表达阳性,同日龄对照组新生小鼠视网膜血管TERT表达阴性.结论高氧诱导视网膜新生血管小鼠模型中端粒酶逆转录酶和新生血管形成相关因子表达水平明显上调,可能会成为视网膜新生血管疾病预防和治疗的新靶点.(中华眼科杂志,2009,45:199-205)     

血管内皮生长因子在氧诱导小鼠新生血管中的表达及意义

目的探讨血管内皮生长因子（VEGF）在小鼠视网膜新生血管中的表达及意义。方法对新生c57BL／6N小鼠高氧后相对低氧饲养，诱导产生视网膜新生血管。在出生后12d、17d摘除眼球，应用RT-PCR，Western Blot以及视网膜血管荧光灌注造影技术检测全视网膜VEGF mRNA、蛋白表达水平以及视网膜新生血管的发生程度。结果视网膜血管造影显示高氧造成血管发育受限，相对低氧后产生新生血管。伴随新生血管的发生，VEGF mRNA升高2．3倍；VEGF蛋白含量也升高7．3倍。结论VEGF表达改变与新生血管发生成正相关，其升高也是造成病理性视网膜新生血管发生的机制之一。减少内源性VEGF表达可能成为治疗视网膜新生血管的新方法。     

转录因子 lslet-1在氧诱导血管增生性视网膜病变中的表达

目的：研究高氧诱导的视网膜新生血管模型鼠中转录因子Islet-1的表达差异。
　　方法：采用高氧诱导的方法制作鼠视网膜新生血管模型,运用荧光造影视网膜铺片及视网膜切片苏木精-伊红染色观察视网膜新生血管的形态。于小鼠出生后第7,12,14,17,26 d取视网膜组织,采用Real-time PCR及Western blot技术测定视网膜组织中Islet-1的表达水平。
　　结果：模型组视网膜铺片及组织切片可见大量视网膜新生血管形成。小鼠出生后第7d,模型组与正常组视网膜组织中Islet-1表达水平无明显差异;小鼠出生后第12~14d,模型组视网膜组织中Islet-1表达水平明显上调;出生后17d,模型组视网膜组织中Islet-1表达水平仍高于正常组;出生后26d,随着视网膜新生血管消退,视网膜组织中Islet-1表达水平降至正常水平。
　　结论：模型鼠视网膜新生血管发生过程中,持续缺氧的视网膜组织通过增加转录因子Islet-1的表达,从而诱导视网膜新生血管的发生。     

转录因子Islet-1在氧诱导血管增生性视网膜病变中的表达

目的:研究高氧诱导的视网膜新生血管模型鼠中转录因子Islet-1的表达差异。方法:采用高氧诱导的方法制作鼠视网膜新生血管模型,运用荧光造影视网膜铺片及视网膜切片苏木精-伊红染色观察视网膜新生血管的形态。于小鼠出生后第7,12,14,17,26d取视网膜组织,采用Real-time PCR及Western blot技术测定视网膜组织中Islet-1的表达水平。结果:模型组视网膜铺片及组织切片可见大量视网膜新生血管形成。小鼠出生后第7d,模型组与正常组视网膜组织中Islet-1表达水平无明显差异;小鼠出生后第12~14d,模型组视网膜组织中Islet-1表达水平明显上调;出生后17d,模型组视网膜组织中Islet-1表达水平仍高于正常组;出生后26d,随着视网膜新生血管消退,视网膜组织中Islet-1表达水平降至正常水平。结论:模型鼠视网膜新生血管发生过程中,持续缺氧的视网膜组织通过增加转录因子Islet-1的表达,从而诱导视网膜新生血管的发生。     

轴突导向因子-1 mRNA在氧诱导血管增生性视网膜病变中的表达

目的研究高氧诱导的视网膜新生血管模型鼠中轴突导向因子-1（Netrin-1）mRNA的表达差异。方法采用高氧诱导的方法制作鼠视网膜新生血管模型;运用荧光造影视网膜铺片及视网膜切片苏木精-伊红染色观察视网膜新生血管的形态。于出生后第12、14、17d取小鼠视网膜,采用RT-PCR测定Netritt-1mRNA的表达水平。结果模型组视网膜铺片及组织切片可见大量视网膜新生血管形成。出生后12d,模型组与正常组视网膜组织中Netrin-1mRNA表达水平无明显差异;出生后14d,模型组视网膜组织中Netrin-1mRNA表达水平明显上调;出生后17d模型组视网膜组织中Netrin-1mRNA表达水平仍高于正常组。结论模型鼠视网膜新生血管发生过程中,持续缺氧的视网膜组织可能从转录水平增加Netrin-1的表达,从而诱导视网膜新生血管的发生。     

Twist基因干扰抑制小鼠视网膜新生血管形成的研究

目的 通过RNA干扰技术抑制小鼠视网膜新生血管形成过程中Twist基因的表达,观察视网膜新生血管内皮细胞的迁移变化和细胞转型规律,寻找抑制视网膜新生血管发生的新靶点.方法 实验研究.取健康C57BL/6J新生小鼠建立高氧诱导小鼠视网膜新生血管动物模型.小鼠生后第12天,分别给予Twist干扰质粒和无关对照质粒玻腔注射治疗.第17天取材,行视网膜Evans蓝灌注铺片、组织病理学检查、新生血管内皮细胞计数和免疫组织化学检测及Real-Time PCR检测.对各组视网膜新生血管内皮细胞计数和Real-Time PCR检测目标基因的表达变化,采用单因素方差分析进行统计学比较.结果 光镜下观察突破内界膜的视网膜新生血管,正常对照组、高氧诱导组、干扰质粒组和对照质粒组突破内界膜的血管内皮细胞平均每眼分别为0.34±0.11、32.73±6.38、4.56±2.02和20.17±6.49.小鼠视网膜Evans蓝灌注铺片观察和石蜡切片HE染色观察显示Twist干扰质粒组小鼠第17天较高氧诱导组视网膜血管迂曲渗漏减轻,新生血管明显减少.Twist干扰质粒组视网膜新生血管内皮细胞计数较高氧诱导组显著减少.免疫组织化学检测可见Twist干扰质粒组小鼠视网膜Twist和波形蛋白表达较高氧诱导组明显减少.使用Real-Time PCR方法检测各组小鼠第17天视网膜Twist基因和波形蛋白基因的表达,Twist干扰质粒组表达较高氧诱导组下调(F=27.214,31.211;P＜0.05).结论 在小鼠视网膜新生血管形成过程中,细胞转型调控的Twist基因发挥重要作用,通过RNA干扰技术抑制Twist基因的表达,可阻遏细胞转型的发生,抑制视网膜新生血管的形成.

Abstract：

Objective The purpose of this research is to find the law of neovascular endothelial cell migration and transition through repressing the expression of Twist in mouse's retinal neovascularization with RNAi, and get a new target of inhibit retinal neovascularization. Methods Oxygen-induced retinopathy (OIR) was produced in new bom C57BL/6J mice by exposing postnatal day 7 (P7) pups to 75% oxygen for 5 days. P12 pups were injected 1 μl pTwist. siRNA plasmid solution or 1 μl negtive siRNA plasmid solution into vitreous cavity. Eyeballs were enucleated for Evans blue angiography, histopathologic examination,neovascular endothelial cell counting, immunohistochemistry and Real-Time PCR. Results Observed by light microscopy retinal neovascularization, the number of vascular endothelial cells per eye were 0.34±0.11,32.73±6.38, 4.56±2.02 and 20.17±6.49 in the normal control group, hyperoxia group,Twist plasmid group and the control plasmid group. Mouse retinal Evans blue perfusion and HE staining of paraffin sections showed that retinal vascular leakage, tortuous and angiogenesis significantly reduced in Twist plasmid group compared with hyperoxia group. Endothelial cell count was significantly decrease in Twist plasmid group. Both immunohistochemistry and real time PCR proved that Twist and vimentin expression in hyperoxia group were significantly higher than that of Twist plasmid group ( F=27.214,31.211 ;P＜0.05). Conclusion As mice retinal neovasculars growth, Twist may play important roles as a cell transition regulatory factor. Repressing Twist with RNAi, we can repress cell transition and inhibit retinal neovascular.     

TERT基因siRNA抑制鼠视网膜新生血管形成的研究

目的 探讨小鼠端粒酶逆转录酶(TERT)小分子干扰RNA(siRNA)对小鼠视网膜新生血管形成的抑制作用,及其用于视网膜新生血管疾病治疗的可行性.方法构建TERT siRNA重组质粒pSIREN-mTERT-1和阴性对照质粒pStREN-mTERT-N.选择7 d龄C57BL/6J小鼠80只随机分为基因治疗组、阴性质粒组、高氧对照组及正常对照组,每组20只.前3组置于75%±2%高氧环境中生活5 d,然后回到正常氧环境中.于第12天出氧舱时,分别向基因治疗组、阴性质粒组两组小鼠玻璃体腔内注射上述两种质粒.正常对照组小鼠正常氧环境中饲养.高氧对照组和正常对照组不予玻璃体腔注射.第19天用2%Evens蓝灌注进行视网膜铺片,观察各组小鼠视网膜血管形态变化;反转录-PCR及Real-time PCR检测各组间TERT mRNA和新生血管相关基因的表达变化;组织切片观察并计数突破内界膜的血管内皮细胞数量.对数据采用单因素方差分析进行统计学比较.结果 荧光造影视网膜铺片显示,基因治疗组整个视网膜血管分布网基本正常,走形较自然,基本接近正常对照组,未见明显的新生血管丛及大片荧光渗漏,只在视网膜中周部及周边部见少许荧光渗漏,但较阴性质粒组及高氧对照组明显减少.阴性质粒组及高氧对照组视网膜血管紊乱,中周部血管迂曲,伴大片荧光渗漏.RT-PCR及实时PCR显示基因治疗组小鼠视网膜TERT mRNA表达为0.56±0.32,明显少于阴性质粒组及高氧对照组(P＜0.05).组织切片HE染色观察,基因治疗组仅见1处新生血管芽,偶见突出内界膜的细胞核;阴性质粒组及高氧对照组见散在突出内界膜伸向玻璃体腔的血管芽,内界膜下出现明显的血管内皮细胞增生;光镜下观察突破内界膜新牛血管内皮细胞计数,基因治疗组(14.62±1.70)较阴性质粒组(32.38±7.50)及高氧对照组明显减少,差异有统计学意义(P＜0.05).结论 TERT特异的siRNA能有效地抑视网膜新生血管动物模鼎视网膜中视网膜新生血管的形成,可能会成为一种治疗视网膜新生血管疾病的新方法.     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.