Apoptosis in cytomegalovirus retinitis associated with AIDS
Apoptosis in cytomegalovirus retinitis associated with AIDS
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DOI：
10.1076/0271-3683(200009)21:3;1-r;ft721
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发表时间：
2000-01-01
影响因子：
2
通讯作者：
Whitcup, SM
中科院分区：
文献类型：
--
作者：
Buggage, RR;Chan, CC;Whitcup, SM
目的。目的探讨细胞凋亡在获得性免疫缺陷综合征患者巨细胞病毒视网膜炎发病机制中的作用。对采用高效抗逆转录病毒治疗前治疗的巨细胞病毒视网膜炎患者43只眼进行常规组织病理学检查和原位细胞凋亡检测(TUNEL法)。通过使用标准分级程序对每个病例的TUNEL阳性细胞数进行量化，对细胞凋亡进行分级，范围从0到3+。使用Armitage程序进行统计分析，描述细胞凋亡分级与CMV活动性感染、脉络膜炎症和玻璃体内缓释更昔洛韦植入物的比例之间的关系。在CMV感染和未感染的41只眼中，28只眼(68%)、13只眼(45%)的活动期和15只眼(55%)的非活动期巨细胞病毒性视网膜炎视网膜细胞发生了凋亡。轻度(1+)14只眼，中度(2+)6只眼，重度(3+)8只眼。无CMVR的两只眼未检测到细胞凋亡。细胞凋亡分级的增加与CMVR的活动性呈正相关(p=0.014)。细胞凋亡与脉络膜炎症之间无明显相关性。玻璃体腔内植入更昔洛韦缓释剂的患者与全身抗病毒治疗的患者相比，细胞凋亡的发生率和严重程度较轻，但差异无统计学意义。在艾滋病相关的巨细胞病毒视网膜炎患者中，细胞凋亡有助于视网膜细胞的丢失，但与治疗后的非活动期CMVR患者视网膜细胞功能的进行性丧失无关。
Purpose. To determine the role of apoptosis in the pathogenesis of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome.Methods. Forty-three eyes from patients with cytomegalovirus retinitis treated before the introduction of highly active antiretroviral therapy were examined by routine histopathology and in situ techniques to detect apoptosis (TUNEL assay). Apoptosis was graded on a scale from 0 to 3+ by quantitating the number of TUNEL positive cells per case using a standard grading procedure. Statistical analysis describing the association between apoptosis grade and the proportions of eyes with active CMV infection, with choroidal inflammation and treated with the sustained-release intravitreal ganciclovir implant was performed using the Armitage procedure.Results. Apoptosis in both CMV infected and uninfected retinal cells was detected in 28 of 41 eyes (68%); 13 (45%) with active and 15 (55%) with inactive cytomegalovirus retinitis. The degree of apoptosis was mild (1+) in 14 eyes, moderate (2+) in 6 eyes and severe (3+) in 8 eyes. Apoptosis was not identified in two eyes without CMVR. An increase in apoptosis grade was positively associated with active CMVR (p = 0.014). There was no significant association between apoptosis and choroidal inflammation. The presence and the severity of apoptosis was less in eyes treated with the sustained-release intravitreal ganciclovir implant compared to those treated with systemic anti-viral therapy, however, the difference was not statistically significant.Conclusions. Apoptosis contributes to retinal cell loss in eyes with cytomegalovirus retinitis associated with AIDS but did not correlate with the progressive loss of retinal cell function in patients with treated, inactive CMVR.