MOOREN ULCER AND EVIDENCE OF STROMAL GRAFT-REJECTION AFTER PENETRATING KERATOPLASTY
MOOREN ULCER AND EVIDENCE OF STROMAL GRAFT-REJECTION AFTER PENETRATING KERATOPLASTY
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DOI：
10.1016/s0002-9394(14)76164-1
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发表时间：
1992-04-15
影响因子：
4.2
通讯作者：
STARK, WJ
中科院分区：
文献类型：
--
作者：
GOTTSCH, JD;LIU, SH;STARK, WJ
一个蚕蚀性溃疡发生在一个6岁的女孩后，穿透性角膜移植术的彼得斯异常。 尽管进行了结膜切除术、角膜粘合、局部和全身给予皮质类固醇和重复移植，但破坏性、周向和向心性基质溃疡复发。 全身和血液流变学检查结果无异常。 供体移植物的组织学评价一致揭示了淋巴细胞和浆细胞浸润。 使用正常供体角膜基质的间接免疫荧光染色在Bowman膜和基质水平呈阳性。 用部分纯化的牛角膜抗原刺激患者的淋巴细胞，在患者血清中发现对相同角膜抗原的阳性抗体滴度。 这些结果表明，体液和细胞介导的免疫机制可能参与穿透性角膜移植术后基质排斥反应过程的启动和持续。
A Mooren's ulcer developed in a 6-year-old girl after a penetrating keratoplasty for Peters' anomaly. A destructive, circumferential, and centripetal stromal ulceration recurred despite conjunctival resection, corneal gluing, topical and systemic administration of corticosteroids, and repeat graftings. Results of a systemic and a rheumatologic examination were unremarkable. Histopathologic evaluations of donor grafts consistently disclosed a lymphocytic and a plasma cell infiltrate. Indirect immunofluorescent staining using a normal donor cornea substrate was positive at the level of Bowman's membrane and stroma. The patient's lymphocytes were stimulated by a partially purified bovine corneal antigen and a positive antibody titer was found in the patient's sera to the same corneal antigen. These results suggest humoral and cell-mediated immune mechanisms can be involved in the initiation and perpetuation of a stromal rejection process after penetrating keratoplasty.