The pathochemistry of the diabetic process in the eye based on data on experimental hyperglycemia (alloxan diabetes)

The paper describes results after a study of pathochemical disturbances of diabetic hyperglycemia on a model of alloxan diabetes. Sugar and amino nitrogen contents in the aqueous humor of the anterior chamber, anterior and posterior segments of the crystalline lens, the iris, ciliary body, choroid and the retina were studied and the data obtained were compared with quantitative contents of sugar and amino nitrogen in the eliminate from the eyes of experimental animals. High amounts of sugar and amino nitrogen, infrequently exceeding 2-3 times in controls, were found to appear in the aqueous humor of the anterior chamber, the crystalline lens, the vitreous body. In all tests the sugar and amino nitrogen contents in the posterior segment of the lens was 10-12% higher than in its anterior segment. The data obtained about accumulation of sugar and amino nitrogen mainly in tissues and media of the eye (the lens, the vitreous) affected by diabetic process already at its early stages widen the knowledge about pathogenesis of the process and peculiarities of its pathochemistry.     

炎性细胞因子在蒸发过强型干眼的发病机制中的作用

目的：探讨炎性细胞因子在蒸发过强型干眼的发病机制中的作用。

方法：选择2010-01/2015-01我院诊治的蒸发过强型干眼患者39例65眼为研究对象。另取健康体检者30例53眼为对照组,对所有患者进行抗炎药物治疗。治疗前测定两组泪液TNF-α、IL-1、IL-6、IL-8水平进行组间比较,并于治疗后1、4、10wk检测试验组上述各炎性因子水平进行组内比较。

结果：对照组的泪液TNF-α、IL-1、IL-6、IL-8水平均显著低于试验组,差异具有统计学意义(P<0.05)。治疗后1、4、10wk时观察指标评价结果存在统计学意义(P<0.05),提示随着治疗时间的延长,患者各项观察指标均逐渐朝向正常值方向变化。治疗后1、4、10wk患者泪液TNF-α、IL-1、IL-6、IL-8比较存在统计学差异,上述各项指标均呈逐渐下降趋势,具有统计学差异(P<0.05)。

结论：TNF-α、IL-1、IL-6、IL-8在蒸发过强型干眼症患者中特异性升高,可作与疾病的发生发展密切相关,可作为临床诊断或疗效监测的重要参考指标。     

炎症介质在干眼发病机制中的作用和抗炎治疗进展

干眼作为多因素引起的复杂疾病,其发病机制也复杂多样,目前认为泪膜不稳定、泪液渗透压升高、眼表炎性和神经异常等为干眼公认的发病机制,并且炎症作为干眼生理病理发病的关键机制被得到证实,为了更全面地了解干眼的炎症级联反应,此次重点讨论与干眼相关的关键因子和细胞介质的作用以及相关抗炎治疗。     

眼手术相关性干眼发病机制的研究进展

随着各类眼科手术的快速发展和广泛开展,术后视觉质量受到了更多的关注。干眼(dry eye)是眼科手术后的常见并发症,常引起眼部不适、视物模糊等症状以及其他干眼体征。眼手术相关性干眼是干眼的一个常见类型,通常由于手术损伤角结膜组织及神经、破坏泪膜稳定性、术后炎症反应以及围术期局部用药等多种因素导致。本文就眼手术相关性干眼的危险因素、不同眼科手术导致干眼的发病机制以及对此类干眼的预防等进行综述,以期眼科医生在临床中能够减少眼手术相关性干眼的发生及发展,提高眼科手术后的视觉质量及生活质量。     

炎症免疫相关信号通路在干眼发病机制中的研究进展

干眼是泪液和眼表的一种多因素疾病,其中炎症是干眼发病机制中最关键的因素,因此干眼的炎症机制及抗炎治疗已成为近年研究的热点。但关于干眼患者眼表所发生的信号传导通路改变目前知之甚少,尤其是炎症因子在干眼中激活相关信号传导通路以及受后者所调控的研究还比较少也比较新。本文主要针对炎症因子在干眼中激活相关信号通路及受相关通路调控的研究进展进行综述。     

The characteristics of the clinical course of the wound process in the eye

Clinical course of wound process in the eye was studied in 279 patients with penetrating wounds of different severity. Modern microsurgical and drug treatment of penetrating wounds results in a favorable course in 2/3 (77.4%) of patients, while in the rest 22.6% the course of healing was complicated by intraocular infection (10.7%) and chronic noninfectious posttraumatic uveitis (11.7%). Risk factors of a complicated course were defined, among which of special importance are specific features of the injury and secondary immunodeficiency, clinically manifesting by chronic inflammatory diseases, predominantly of the ENT organs and bronchopulmonary system.     

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。     

干眼症的发病机制

眼表（角膜、结膜、副泪腺和睑板腺）、主泪腺和它们之间的神经连接组成的泪腺功能单位共同发挥对泪液分泌和泪膜形成的调控作用,维护眼表的健康,其中任一环节的损害均可导致泪膜完整性和正常功能的破坏.引起干眼症的起始病因很多,如果这些因素在未引起眼表改变时消失,则泪膜恢复正常;如这些因素不能消失,则引起眼表面的病理改变.虽然干眼症的临床表现类型不同,但其病理生理改变是相似的,炎症是干眼症发病机制中最关键的病理生理改变,而细胞凋亡、神经调节及性激素等也共同参与了干眼症的发病过程.     

A study of total IgE in inflammatory pathologies of the eye anterior segment

The paper contains data on comparative research of the IgE content in blood serum and lachrymal fluid in patients with ophthalmoherpes and with other inflammatory diseases of the eye. A higher IgE level was found in blood serum and lachrymal fluid in cases of ophthalmoherpes as well as in lachrymal fluid in cases of allergic, Chlamydia and fungus diseases of the eye. The data obtained can be used in the diagnostics of allergic eye diseases as well as in elaborating complex treatment methods for herpetic, Chlamydia and fungus lesions of the anterior eye segment. A detection of the local allergenic effect of acaricide drugs exerted on the conjunctiva and eyelids makes it obligatory to consider the above fact while treating patients with demodectic blepharoconjunctivitis.     

Sclerosing inflammatory pseudotumor of the eye

We report the clinical course and pathologic findings in a case of intraocular sclerosing inflammatory pseudotumor in a 21-year-old man. The patient initially had a unilateral right interstitial keratitis, scleritis, uveitis, ciliary body mass, and retinal detachment. Scleral and vitreous biopsy specimens revealed an inflammatory process. The eye was eventually enucleated despite therapy with high doses of prednisone and ciprofloxacin hydrochloride. Histologic examination of the globe showed nongranulomatous, acute (neutrophils) and chronic (lymphocytes and histiocytes) inflammation with proliferation of fibrous tissue within the vitreous cavity, uvea, sclera, and contiguous orbital fibroadipose tissue. The contralateral eye later developed a similar mass that resolved following aggressive and prolonged immunosuppressive therapy with retention of 20/16 visual acuity.