角膜新生淋巴管的研究进展

角膜新生淋巴管多见于感染、炎症、外伤或角膜移植术后.临床上,如何有效的防治角膜移植术后排斥反应是角膜移植手术成功的关键.随着近年来角膜新生淋巴管内皮特异性标记物及重要淋巴管生长因子的相继发现,人们对角膜新生淋巴管的生成机制及与角膜移植排斥反应的关系有了深入的研究,此文就新生淋巴管的生成及其在角膜移植排斥中的作用作一综述.     

特异性促炎症消退介质在眼表疾病中的研究进展

特异性促炎症消退介质(SPM)是一类由多不饱和脂肪酸代谢产生并介导炎症消退反应的脂质介质。SPM信号分子及其受体在眼表组织与细胞高度表达,共同构成内源性SPM网络,对于维持眼表健康和免疫稳态具有重要作用。近年来研究表明,SPM及其类似物在促进角膜伤口愈合与角膜神经再生的同时,还可抑制角膜移植排斥反应、过敏性结膜炎、微生物角膜炎的免疫炎症反应,并有望成为治疗干眼的潜在性药物靶点,同时为眼表疾病的发病机制研究与临床诊治提供了新的思路。本文将就SPM在维持眼表稳态的重要作用及其在多种眼表疾病中的治疗潜力进行综述。     

角膜新生淋巴管的分子免疫学研究进展

角膜新生淋巴管构成了角膜免疫反应的传入弧,它与角膜新生血管的协同作用是破坏角膜免疫赦免机制的关键因素.近年来,随着淋巴内皮细胞特异性标志物的相继发现,有关角膜淋巴管生成因子的生物学特性、调节机制及临床意义等方面的研究有很大进展.角膜新生淋巴管的免疫调节作用及与移植排斥反应的关系成为研究热点.为此,本文结合角膜免疫赦免特点对角膜新生淋巴管生成的调控机制及其与角膜移植排斥反应之间的关系作一综述.     

调节性T细胞在角膜移植排斥反应中的研究进展

角膜移植术是治疗终末期角膜疾病的常用方式,虽然角膜移植的成功率较其它器官移植高,但是术后排斥仍然是手术失败的主要原因。器官移植后排斥反应高度依赖于免疫细胞向淋巴组织或炎症部位的定向迁移和归巢,并受粘附分子和趋化因子的调控。调节性T细胞在免疫调节中起着关键性作用,通过诱导免疫耐受维持内环境稳定,在器官移植排斥反应、自身免疫性疾病及肿瘤相关研究中发挥重要作用。本篇综述主要介绍调节性T细胞参与眼部免疫耐受的相关研究,着重阐述调节性T细胞在角膜移植排斥过程中的作用、机制和应用。     

角膜移植术后角膜免疫排斥反应的临床探讨

目的 探讨角膜移植术后角膜免疫排斥反应的有效防治方法。方法 对穿透角膜移植术后发生角膜免疫排斥反应的68例(68眼)进行回顾性总结。 结果 经统计学分析结果表明:角膜化学烧伤、角膜新生血管、大植片移植、术前活动性角膜炎症、再次移植等均为穿透角膜移植术后免疫排斥反应的主要因素。 结论 免疫排斥反应的发生与术前高危角膜移植有着非常密切的关系。     

间充质干细胞在角膜损伤修复和角膜移植中的应用

严重损伤后角膜的修复及角膜移植后的抗免疫排斥反应是角膜疾病治疗中的重点和难点.间充质干细胞可在特定环境下诱导分化为角膜上皮细胞、角膜基质细胞等细胞类型,或通过旁分泌作用抑制炎性反应及新生血管的生成,进而保护损伤组织,促进角膜修复.此外,间充质干细胞还具有抗炎和调节免疫的特性,使其在抗角膜移植排斥反应中发挥作用.     

共刺激分子Tim-1在角膜移植排斥反应中的作用

背景 角膜移植是目前临床上治疗角膜盲可靠且有效的复明手段,角膜移植术后的免疫排斥反应是角膜移植失败的主要原因. 目的 研究共刺激分子Tim-1在大鼠角膜组织中的表达及其在角膜移植排斥反应发生和发展过程中的作用.方法 40只清洁级成年雌性Wistar大鼠随机分为正常对照组、自体角膜移植组和同种异体角膜移植组.正常对照组大鼠未行任何手术,自体角膜移植组分别以Wistar大鼠作为供体和受体施行穿透角膜移植术,而同种异体角膜移植组以SD大鼠角膜作为供体,Wistar大鼠作为受体行穿透角膜移植术,各组供体角膜植片均为3.5mm,植床直径为3.0 mm.分别于术后7d、14d在裂隙灯显微镜下观察术眼角膜炎症反应情况,按照Larkin的标准进行排斥反应评分,计算排斥反应指数（RI）,观察各组角膜植片的平均存活时间和植片存活率.术后7d、14d,3个组各取3只大鼠眼球制备角膜组织切片,分别行组织病理学检查和免疫组织化学检测,观察角膜组织的炎症反应和共刺激分子Tim-1蛋白在角膜组织中的表达;此外分别于术后7d、14d各组取5只大鼠角膜制备组织匀浆,采用实时荧光定量PCR法检测共刺激分子Tim-1 mRNA在大鼠角膜植片中表达量（吸光度,A）的变化.结果 术后7d,自体角膜移植组和同种异体角膜移植组大鼠角膜植片均出现轻度水肿;术后14 d,自体角膜移植组角膜植片水肿消失,植片透明,而同种异体角膜移植组大鼠角膜植片水肿增厚,呈灰白色混浊,可见新生血管形成.自体角膜移植组植片的存活率为100％,同种异体角膜移植组植片存活率为0,平均生存时间为（9.8±1.2）d.组织病理学检查表明,术后7d自体角膜移植组植片基质层可见炎性细胞浸润,但术后14d炎性细胞明显减少;同种异体角膜移植组术后7d植片水肿,基质层可见炎性细胞浸润,术后14 d阳性细胞大量增加,可见新生血管.免疫?     

树突状细胞在角膜移植免疫排斥反应中的作用

角膜移植术后的免疫排斥反应是导致手术失败的主要原因,树突状细胞在角膜移植免疫排斥反应中起着多方面作用,其作用机制成为研究热点.近年来,通过角膜移植动物模型发现,树突状细胞能够诱导不同类型的免疫反应.通过减少树突状细胞数量、抑制树突状细胞提供双信号的能力以及通过树突状细胞诱导免疫耐受等防治角膜移植免疫排斥反应的研究方法,目前取得了一定进展.     

穿透性角膜移植排斥反应的免疫学机制

尽管角膜具有众多特殊的免疫赦免机制,但CD4+T细胞为主介导的角膜移植排斥反应仍是术后最常见的并发症.本文从高危角膜移植对免疫赦免状态的影响、角膜免疫机制的应答以及排斥反应的预防及治疗几个方面阐述角膜移植排斥反应的最新进展.     

Toll样受体在干眼发病机制中的研究进展

最近研究显示眼表引发免疫炎症反应的部分原因是眼表存在一类称为Toll样受体（TLRs）的蛋白家族。TLRs在眼部的表达受到感染和各种炎症环境的影响,例如单疱病毒、细菌、真菌性角膜炎,变态反应性结膜炎和干眼综合征。TLRs信号通路对抗原递呈细胞和T细胞介导的免疫炎症反应的激活起重要作用。近些年随着眼科学的发展,对TLRs在干眼发病机制方面的研究逐渐增多,现就TLRs的结构与配体,TLRs的信号转导路径,TLRs在眼表中的表达位置及表达模式,以及与干眼的相关性作一综述。     

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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Current Thoughts on the Aetiology of Ocular Changes during Contact Lens Wear

ABSTRACT: Contact lenses are known to produce changes to the ocular tissues, and this review attempts to give a comprehensive assemblage of the knowledge on the aetiology of such changes. To achieve this result, the changes are categorized by structure and function, and discussed according to the temporal nature of occurrence where appropriate. Although assessment of the importance of a particular tissue change is difficult, this overview enables some degree of judgement to be made on the aetiology of the major side-effects of contact lens wear. This gives a basis on which to modify aspects of contact lens wear to ultimately increase the success rate.     

The detection of motion in chromatic stimuli: first-order and second-order spatial structure

This study provides evidence for the existence of a low-level chromatic motion mechanism and further elucidates the conditions under which its operation becomes measurable in an experimental stimulus. Observers discriminated the direction of motion of amplitude modulated (AM) gratings that were defined by luminance or chromatic variation and masked with spatiotemporally broadband luminance or chromatic noise. The size and retinal location of the stimuli were varied and the effects of broadband noise and grating masks were both compared with the cohort of stimuli. Some significant disparities in the published literature were well explained by the results. In conclusion, evidence for a chromatically sensitive motion mechanism that evades the, detrimental effects of a luminance mask was found only at the fovea and only when the stimulus was small and centrally placed.     

Local chemotherapeutic agents for the treatment of ocular malignancies

We critically analyze available peer-reviewed literature, including clinical trials and case reports, on local ocular cancer treatments. Recent innovations in many areas of ocular oncology have introduced promising new therapies, but, for the most part, the optimal treatment of ocular malignancies remains elusive.