Graves眼病患者球后组织免疫组化研究

目的：为了探讨Ｇｒａｖｅｓ眼病的确切发病机制。方法：应用单克降抗体人类白细胞ＤＲ抗原（ＨＬＡ－ＤＲ）、巨噬细胞（ＣＤ６８）、第八因子相关性抗原（Ｆ８／８６）、Ｔ细胞（ＣＤ３）、辅助性／诱导Ｔ细胞（ＣＤ４）、抑制性／细胞毒Ｔ细胞（ＣＤ８）、Ｂ细胞（ＣＤ２０）对１４例Ｇｒａｖｅｓ眼病患者球后组织主要为眼餐肌标本冰并或石蜡切用碱性磷酸酶－抗碱磷酸酶（ＡＰＡＡＰ）法进行免疫组织化学研究，５例正常人眼外肌作

An immunohistochemical study of retrobulbar tissues of patients with Graves Ophthalmopathy

Our study is to inyestigate the pathogenesis of Graves Ophthalmopathy. 17 retrobulbar tissue specimens frum 14 cases with Graves OphthalmOPatby (GO) were studied by immunohistochemical staining of APAAP essay with mono-antibodies of HLA-DR,CD68, F8/86,CD3, CD4,CD20.5 normal extraocular muscle specimens seryed as the control. We found:(1)The muscle cell of GO was not stained with HLADR while the interstitial cells were strong positive.All of the DR cells were macrophages (CD68 ), infiltrated lymphocytes, capillary cells (F8/86 ) and fibroblast-like cells. (2) The CD68 staining showed that there were enormous macrophages in the extraocular muscles of GO. (3) F8/86 staining showed that the extraocular muscles vascularized and the vessels dilated. (4) The extraocular muscles of GO had diffuse and/or local lymphocytes infiltrations,the majority of which were T lymphocytes (CD3 )and a few B cells(CD20 ). There was a slight predominance of CD4 T cells over CD8 cells. Most lymphocytes were HLA-DR positive. 5 cases showed that no lymphocytes infiltrated in extraocular muscles.(5) The retrobulbar fat tissue did not react with antibodies above. Our study suggests that extraocular muscles are the main site of the autoimmune process in GO. The aberrant expression of HLA-DR antigen by the interstitial cells of extraocular muscles of GO maybe play an important role in inducing and strengthening auto-immunological reaction. Cell-immune may be important to local inflammation.