Pseudodentritic keratitis associated with meibomitis in young healthy males

PURPOSE: To report unusual corneal manifestations of pseudodendritic keratitis in cases of coexisting meibomian gland dysfunction (MGD). METHODS: Retrospective chart review of five cases of MGD with associated atypical corneal lesions was carried out. Information including patient's age, symptoms and their duration, clinical features, methods of diagnosis, treatment, and outcome were abstracted from the medical records. Pseudodendritic keratitis and MGD was defined before the data collection. RESULTS: All five patients were males within the age range of 6-24 years. Common symptoms were irritation and watering. MGD, which was defined as stenosis of meibomian gland orifices and/or turbid meibomian secretions, was seen in all the patients. Corneal lesions were epithelial, raised and dendritic in morphology. Blood investigations carried out to rule out tyrosinemia in three of the patients were negative. Bandage contact lens facilitated disappearance of these lesions in five eyes. CONCLUSIONS: Corneal involvement in the form of pseudodendritic keratitis may be associated with MGD. Application of bandage contact lens facilitated prompt resolution, suggesting mechanical factor with or without other etiological factors may be at interplay in producing these innocuous corneal lesions.     

糖尿病视网膜病变患者外周血内皮祖细胞数量及功能的变化

目的 观察糖尿病视网膜病变(DR)患者外周血内皮祖细胞(EPC)数量及功能变化.方法 选取DR患者12例(DR组)、糖尿病(DM)患者18例(DM组)及无DM的老年性白内障患者15例(对照组)纳入研究.密度梯度离心法收集各组患者外周血单个核细胞,培养后第10天采用流式细胞仪计数EPC细胞阳性率.采用二苯基四氮唑嗅盐(MTT)比色法、黏附能力测定实验及Transwell实验检测EPC的增生、黏附和迁移能力.结果 流式细胞仪检测结果显示,对照组、DM组及DR组培养后第10天EPC细胞阳性率分别为(45.190±1.287)％、(30.130±3.245)％、(37.370±2.501)％;3组间差异有统计学意义(F=27.690,P=0.001).MTT比色法检测结果显示,对照组、DM组及DR组吸光度[A,旧称光密度(OD)]值分别为0.330±0.047、0.225±0.042、0.120±0.029;3组间差异有统计学意义(F=29.327,P=0.000).黏附能力测定实验结果显示,对照组、DM组及DR组EPC细胞数分别为76.400±7.503、51.167±6.646、26.500±7.853;3组间差异有统计学意义(F=56.612,P=0.000).Transwell实验结果显示,对照组、DM组及DR组EPC细胞数分别为23.600±6.504、20.833±4.491、12.000±2.944;3组间差异有统计学意义(F=6.477,P=0.012).结论 DR患者外周血EPC数量减少,且其增生、黏附和迁移能力受损.     

协同刺激分子在单纯疱疹性角膜基质炎鼠外周血中的表达

目的研究鼠单纯疱疹性角膜基质炎发生和发展过程中协同刺激分子在外周血中的表达水平,探讨协同刺激分子的表达与单纯疱疹性角膜基质炎之间的关系。方法用单纯疱疹病毒1型(herpessimplexvirustype1,HSV1)接种于BALB/c鼠角膜上建立单纯疱疹性角膜基质炎(herpeticstromalkeratitis,HSK)动物模型,分别于角膜接种病毒前和接种病毒后的第1d、3d、7d、10d、14d、21d及28d,用毛细管取小鼠的左眼眼眶静脉窦血1mL,提取淋巴细胞,用半定量逆转录聚合酶链反应检测协同刺激分子B71、B72、CD28、CTLA4的表达水平;同时,在裂隙灯显微镜下观察鼠角膜的临床变化。结果HSV1感染鼠的角膜后,小鼠均患了急性角膜上皮炎,并于感染后1周内痊愈。86.7%(78/90)的小鼠自感染病毒后第10d起开始出现角膜基质炎改变,典型的表现为灶状角膜基质混浊,局部角膜新生血管化,炎性细胞浸润。角膜基质混浊逐渐进展,于3周时达到高峰,4周时开始修复。鼠在感染病毒之前,外周血中表达微弱的CD28mRNA,不表达CTLA4、B71及B72mRNA。鼠感染病毒后,外周血中CD28、CTLA4和B71的表达量均显著增加,B72仍无表达;CD28在HSK的发生和发展过程中表达水平较高,在疾病愈合过程中表达减弱;B71表达的高峰时间是病毒感染后的3～21d,以稍低的表达水平平行于CD28的表达。结论在鼠单纯疱疹性角膜基质炎的发病过程中,协同刺激分子CD28/CTLA4:B71在外周血中的表达明显增强,在诱导CD4 T细胞介导的单纯疱疹性角膜基质炎中起关键性作用。     

复发性病毒性角膜炎外周血T细胞的变化

目的：研究复发性病毒性角膜炎患者外周血T淋巴细胞亚群、T细胞激活状态及Th1／Th2模式，进一步探讨其免疫发病机制。方法：运用流式细胞仪检测30例复发性病毒性角膜炎患者血浆TH1（IFN-γ，TNF-α，IL-2），TH2（IL-10，IL-5，IL-4）细胞因子水平以及外周血淋巴细胞CD3^＋，CD4^＋，CD8^＋T细胞和CD3^＋HLA-DR^＋，CD4^＋HLA-DR^＋，CD8^＋HLA-DR^＋T细胞百分率，并与健康对照组比较。结果：复发性病毒性角膜炎患者血浆IFN-γ，IL-2水平有明显上升（P〈0．05）；IL-4水平下降（P〈0．05）。CD4^＋细胞下降（P〈0．05）；CD4^＋HLA-DR可及CD8^＋HLA-DR^＋T可细胞上升（P〈0．05）。结论：复发性病毒性角膜炎患者T细胞过度活化和TH1／Th2平衡的偏离；Th1激活增强，Th2激活减弱与病毒性角膜炎的复发、迁延有关。     

单疱病毒性角膜炎患者外周血几种细胞因子水平的改变及临床意义

目的：探讨几种细胞因子在单疱病毒性角膜炎（herpes simplex keratitis,HSK)发病机理中的作用及意义。方法：用双抗体夹心法酶联免疫吸附试验（ELISA）对51例HSK患者（其中活动期33例,非活动期18例）作了外周血白细胞介素6（IL－6）、白细胞介素8（IL－8）、α肿瘤坏死因子（TNF－α）、α干扰素（TNF－α）水平观察,并用同样方法以50名正常献血员作正常对照。结果：HSK活动期患者的IL－6、IL－8、TNF－α测定值与HSK非活动期患者和正常对照组相比明显增高;IFN－α与HSK非活动期患者和正常对照组比较显著降低,差异均有非常显著性（P＜0．01）;基质型HSK患者与上皮型HSK患者IL－6、IL－8、TNF－α相比,差异有非常显著性（P＜0．01）。结论：HSK患者正常免疫功能受抑制几种细胞因子水平异常可能导致HSK的发生与发展,IL－6、IL－8、TNF－α、IFN－α的测定,可作为HSK患者治疗观察及愈后评估的参考指标。     

A case of peripheral ulcerative keratitis associated with neutrophilic dermatosis of the dorsal hand

We report a case of peripheral ulcerative keratitis associated with neutrophilic dermatosis of the dorsal hand, a recently described clinical entity. A 68-year-old man presented with concurrent peripheral ulcerative keratitis of the right eye and neutrophilic dermatosis of the dorsal hand causing pustular skin eruptions on the dorsal surface of both hands. Systemic investigations suggested an underlying diagnosis of Wegener's granulomatosis. To our knowledge this is the first reported case of neutrophilic dermatosis of the dorsal hand associated with ocular complications.     

A cell line and clones of lymphocytes from a healthy donor, with specificity to S-antigen

Retinal-specific antigens can induce autoimmune diseases in eyes of immunized experimental animals and are thought to be involved in certain uveitic conditions in man. We have recently found that peripheral blood lymphocytes from a large proportion of healthy donors react in culture against the retinal S-antigen (S-Ag), when tested by a modified sensitive assay. The investigation of this responsiveness was extended by isolation and characterization of a cell line and clones specific to S-Ag from the blood of a healthy donor. Characterization of the cell line and clones by flow cytometry showed that these lymphocytes carried antigens specific for helper/inducer T cells (CD3 and CD4). The response of the cell line and clones to S-Ag depended completely on added antigen-presenting cells (APC), and was MHC-restricted; no response was observed in cultures with APC carrying incompatible MHC antigens. The cell line and clones reacted to S-Ag considerably more vigorously than the freshly collected blood lymphocytes from the same donor. These data thus provide additional support to the notion that lymphocytes with reactivity toward retinal specific antigens are present in the circulation of normal donors. The possibility that such cells could be involved in pathogenic autoimmune processes in the eye is discussed.     

辛伐他汀对糖尿病视网膜病变大鼠外周血内皮祖细胞数量和视网膜病变的影响

目的 探讨辛伐他汀对糖尿病视网膜病变(DR)大鼠外周血内皮祖细胞(EPCs)数量及视网膜病变的影响.方法 雄性成年Wistar大鼠80只,以随机数字表法分为正常对照组、模型对照组、安慰剂组、辛伐他汀组,每组各20只大鼠.采用腹腔注射链脲佐菌素(STZ)建立DR大鼠模型.正常对照组、模型对照组不给予任何干预;辛伐他汀组予辛伐他汀20 mg/kg灌胃,1次/d;安慰剂组给予等量蒸馏水灌胃,1次/d.分别于1、4及12周时取静脉血,采用流式细胞仪分别计数各组大鼠外周血EPCs数量的变化.于12周时处死大鼠,摘除眼球行苏木精-伊红(HE)染色,采用伊文思蓝(EB)定量检测血视网膜屏障的破坏程度,免疫组织化学法分析CD31在大鼠视网膜中的表达.实时定量逆转录聚合酶链反应检测内皮型一氧化氮合酶(eNOS)、诱导型一氧化氮合酶(iNOS)及血管生成素-1(Ang-1)在视网膜的表达.对比分析EPCs的数量改变与视网膜病理变化的相互关系.结果 与正常对照组大鼠相比,注射STZ后1、4、12周时安慰剂组大鼠外周血EPCs数均降低;注射STZ后1、4、12周时辛伐他汀组大鼠外周血EPCs数明显高于模型对照组和安慰剂组,差异均有统计学意义(t=4.967,5.648,6.688,6.042,7.392,7.454;P＜0.05);模型对照组和安慰剂组大鼠外周血EPCs数相比,差异无统计学意义(t=0.525,-0.249,-0.619;P＞0.05);正常对照组和辛伐他汀组大鼠外周血EPCs数相比,差异均有统计学意义(t=6.733,2.794,-5.535;P＜0.05).组织病理学检查显示,正常对照组大鼠视网膜各层结构清晰、排列整齐、形态正常;模型对照组和安慰剂组大鼠视网膜细胞排列紊乱,细胞核肿胀、体积增大,视网膜组织水肿;辛伐他汀组大鼠视网膜各层组织水肿减轻,细胞排列渐规则.模型对照组和辛伐他汀组大鼠视网膜平均EB渗漏量较正常对照组显著增加,辛伐他汀组较模型对照组明显减少,差异均有统计学意义(F=65.808,P＜0.05).正常对照组、模型对照组和安慰剂组中表达CD31的阳性细胞数显著低于辛伐他汀组,组间CD31阳性细胞数比较,差异有统计学意义(F=24.799,P＜0.05);eNOS在模型对照组表达较正常对照组明显减弱,辛伐他汀组表达强度较模型对照组增强(t=-2.750,2.230;P＜0.05);iNOS和Ang-1在模型对照组表达较正常对照组明显增强,辛伐他汀组表达强度较模型对照组减弱,差异均有统计学意义(t=3.881,-1.144,4.244,-1.458;P＜0.05).安慰剂组视网膜EB渗漏量、eNOS、iNOS及Ang-1的相对表达量与模型对照组相比,差异均无统计学意义(t=0.480,-0.877,0.062,0.220;P＞0.05).结论 辛伐他汀可动员DR大鼠外周血EPCs,诱导视网膜内皮细胞迁徙分化,减缓DR进展.其可能机制为调节eNOS和iNOS等内皮形成相关因子.     

增生型糖尿病视网膜病变患者外周血内皮祖细胞的数量变化及意义

目的 观察增生型糖尿病视网膜病变(PDR)患者外周血内皮祖细胞(EPCs)数量的变化规律,探讨EPCs在糖尿病视网膜病变(DR)发病机制中的作用.方法 PDR患者40例(PDR组)、单纯2型糖尿病患者30例(糖尿病组)及健康体检者20名(对照组)纳入研究.抽取3组受检者晨起空腹静脉血2 ml,反复离心过滤.采用流式细胞仪分析2×105个细胞,以CD34和(或)CD133双阳性细胞群为EPCs,观察并比较3组受检者外周血EPCs数量变化;同时分析PDR患者外周血EPCs数量与DR病程、糖化血红蛋白及血脂的相关性.结果 PDR组、糖尿病组及对照组受检者外周血EPCs计数分别为(49±12)、(35±11)、(90±25)个/ml,3组间差异有统计学意义(F=56.260,P＜0.05).相关性分析发现,PDR患者外周血EPCs数量与DR病程呈正相关(r=0.564,P＜0.05),与糖化血红蛋白(r=-0.170,P>0.05)及血脂(r=0.261,P>0.05)均无相关性.结论 PDR患者外周血EPCs数量较正常者明显降低;EPCs在DR发病机制中可能具有一定作用.

Abstract：

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.     

增生型糖尿病视网膜病变患者外周血内皮祖细胞的数量变化及意义

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.     

增生型糖尿病视网膜病变患者外周血内皮祖细胞的数量变化及意义

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.     

胸腺肽应用于复发性单纯疱疹病毒性角膜炎外周血T淋巴细胞亚群观察

目的:探讨胸腺肽(thymosin)治疗复发性单纯疱疹性病毒性角膜炎外周血T淋巴细胞亚群。方法:收集复发性单纯疱疹病毒性角膜炎患者33例、健康对照者28例,应用流式细胞仪技术测定T细胞亚群。结果:复发性单纯疱疹病毒性角膜炎患者治疗前CD3、CD4明显下降(P<0.05),CD8升高,CD4/CD8比值下降(P<0.05)。23例痊愈患者治疗后T淋巴细胞亚群接近正常水平,而6例未痊愈患者治疗后T淋巴细胞亚群虽有所提高,但仍低于健康对照(P<0.05)。结论:复发性单纯疱疹病毒性角膜炎患者细胞免疫功能降低,胸腺肽肠溶片能够增强患者细胞免疫功能,取得较好效果。     

Neural stem/progenitor cells circulating in peripheral blood of patients with neovascular form of AMD: a novel view on pathophysiology

Background  

The neovascular form of age-related macular degeneration (AMD) manifested with choroidal neovascularization (CNV) is one of the leading causes of rapid and irreversible visual loss. Recent reports suggest that bone marrow-derived stem/progenitor cells (SPCs) play a crucial role in the development and progression of the disease. The purpose of this study was to investigate whether or not undifferentiated non-haematopoietic stem cells, including those capable of differentiating into neural phenotypes, play a role in the pathological state of CNV formation.     

中药对单纯疱疹性角膜炎患者外周血T细胞亚群的影响

目的：探讨中药对单纯疱疹性角膜炎患者外周血Ｔ细胞亚群的影响。 方法用 ＯＫＴ单克隆抗体检测了 １１２例单纯疱疹性角膜炎，随机分为中药治疗组 ６０例，西药对照组 ５２例。 结果中药治疗组治愈率为８６．６％，总有效率为９８． ３３％；西药对照组治愈率为７１．１５％，总有效率为９０．３８％；两组差异有显著性（Ｐ＜０．０５）。外周血Ｔ细胞亚群：治疗前，两组患者辅助性Ｔ细胞（Ｔｈｅｌｐｅｒ ｌｙｍｐｈｏｃｙｔｅ，ＴＨ）的比例明显低于抑制性 Ｔ细胞（Ｔ ｓｕｐｐｒｅｓｓｏｒ ｌｙｍｐｈｏｃｙｔｅ，ＴＳ）（Ｐ＜０．０１）；中药治疗组ＴＨ治疗后较治疗前有明显提高（Ｐ＞０． ０５），而西药对照组治疗后 ＴＨ 较治疗前虽有提高，但差异无显著意义（Ｐ＞０．１）。 结论单纯疤疹性角膜炎患者服中药后，体内ＴＨ增加，细胞免疫功能增强。