玻璃体内注射他克莫司对异种移植的视网膜色素上皮细胞存活的影响

目的 观察少量、多次玻璃体内注射免疫抑制剂他克莫司（FK506）对移植到兔眼视网膜下间隙内的人视网膜色素上皮（retinal pigment epithelium, RPE）细胞存活情况的影响。 方法 采用绿色荧光蛋白（green fluorescent protein, GFP）逆转录病毒感 染人RPE细胞。将50 μl（4×10³个/μl）表达GFP的人RPE细胞悬液注射到18只白兔及1 0只灰兔双眼视网膜下间隙，手术后所有兔左眼玻璃体内注射5 μl FK506（5 μg/ μl），每周1次，连续5周，然后间周一次至20周;右眼不注射作为对照。眼球壁铺片倒置荧光 显微镜观察移植细胞的存活状态。 结果 白兔于移植后1、2、3、4 、6、10、11、14、18、20、23、24、25、33、54周，灰兔于移植后4、5、6、7、14、18、20、26周双眼视网膜下均可见表达的GFP细胞，但移植术后1~14周内玻璃体内注射了FK506的左眼视网膜下RPE-GFP细胞形态、细胞膜的完整程度均比未注射的右眼好。18周后，7只白兔和3只灰兔双眼视网膜下移植细胞的状态差异不明显。眼球切片苏木素-伊红（hematoxylin-eosin, HE）染色观察结果显示，移植术后1~6周，6只白兔和3只灰兔右眼脉络膜小血管周围可见灶性或弥散的淋巴细胞，应用了FK506的左眼淋巴细胞的浸润明显减少。 结论 移植术后早期玻璃体内使用小剂量免疫抑制剂可减轻局部炎症反应，有利于维持视网膜下间隙移植的异种细胞的存活。 （中华眼底病杂志，2003，19：333-404）

Effect of intravitreal injection of FK506 on the survival of heteroplastic retinal pigment epithelial cells

Objective To investigate effect of intravitreal injection of FK506 on the survival of human retinal pigment epithelial (RPE) cells heter oplastically transplanted into the subretinal space of rabbits.Methods The immortalized human RPE cells were genetically labeled by retrovirus vector carrying a green fluorescent protein (GFP). A total of 50 μl RPE cells suspension with 4×10³ cells/μl which expressed GFP were injected into the subretinal space of both eyes of 18 white rabbits and 10 gray rabbits. The left eyes of all of the rabbits were injected of 5 μl FK506 (5 μg/μl) intravitreally once a week during the first 5 weeks, then once every other week until the 20th week and the right eyes were as the control. The histological sections of heteroplastic RPE cells were observed by epifluorescent microscope.Results GFP-expressing cells could be seen after 1 week, 2, 3, 4, 6, 10, 11, 14, 18, 20, 23, 24, 25, 26, 33, and 54 weeks in white rabbits and after 4 , 5, 6, 7, 14, 18, 20, and 26 weeks in gray rabbits. The configuration and integrality of the RPE-GFP cells in the left eyes which had been intravitreally injected of FK506 1-14 weeks after transplantation were better than those in the right eyes without injection. After 18 weeks, the condition of heteroplastic cells with few difference in both eyes in 7 white and 3 gray rabbits were found. After 1-6 weeks, focal and disseminated lymphocytes around the choroidal small vessles of right eyes in 6 white and 3 gray rabbits could be seen while the infiltration of the lymphocytes in the left eyes was much reduced.Conclusion Intravitreal injection of a small amount of FK506 at the first 3 months after transplantation may significantly improve the survival of heteroplastic RPE cells in the subretinal space of rabbits. (Chin J Ocul Fundus Dis，2003，19：333-404)