Immunopathogenesis of conjunctival scarring in trachoma
Immunopathogenesis of conjunctival scarring in trachoma
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DOI：
10.1038/eye.1998.104
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发表时间：
1998-06-01
期刊：
影响因子：
3.9
通讯作者：
Desmet, V
中科院分区：
文献类型：
--
作者：
Abu El-Asrar, AM;Geboes, K;Desmet, V
沙眼是由沙眼衣原体感染引起的一种慢性滤泡性结膜炎，是导致可预防失明的主要原因。致盲并发症与进行性结膜瘢痕有关，这可能是由免疫介导的反应引起的。我们通过研究结膜中纤维原性细胞因子的表达，研究了沙眼炎症和纤维化的调节过程。方法对9例活动性沙眼患者和4例对照患者的结膜活检标本进行研究。我们使用免疫组织化学技术和一组针对白细胞介素-1 α (IL-1 α)、白细胞介素-1 β (IL-1 β)、肿瘤坏死因子- α (tnf - α)和血小板衍生生长因子（PDGF）的单克隆和多克隆抗体。此外，我们通过使用一组单克隆抗体来表征炎症浸润的组成。用天狼星红和Van Gieson染色来表征固有质纤维组织的范围。结果沙眼标本炎性细胞数量明显高于对照标本。细胞因子在正常结膜中无表达。所有沙眼标本的结膜上皮均有胞浆IL-1 α和IL-1 β的表达。浸润固有质的巨噬细胞中检测IL-1 α、IL-1 β、tnf - α和PDGF。在6个沙眼活检中，B淋巴细胞多于T淋巴细胞，纤维化局限于深部固有质，而在3个活检中，T淋巴细胞多于B淋巴细胞，纤维化更广泛。在所有沙眼活检中，辅助/诱导T淋巴细胞数量超过抑制/细胞毒性T淋巴细胞。结论局部IL-1 α、il - β、tnf - α和PDGF的表达上调可能与沙眼结膜损伤和瘢痕形成有关。
Purpose Trachoma, a chronic follicular conjunctivitis caused by infection with chlamydia trachomatis, is the leading cause of preventable blindness. The blinding complications are associated with progressive conjunctival scarring that may result from immunologically mediated responses. We studied the processes involved in the regulation of inflammation and fibrosis in trachoma by investigating the expression of fibrogenic cytokines in the conjunctiva.Methods We studied conjunctival biopsy specimens obtained from nine subjects with active trachoma and from four control subjects. We used immunohistochemical techniques and a panel of monoclonal and polyclonal antibodies directed against interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), tumour necrosis factor-alpha (TNF-alpha) and platelet-derived growth factor (PDGF). In addition, we characterised the composition of the inflammatory infiltrate by the use of a panel of monoclonal antibodies. Sirius red and Van Gieson stains were used to characterise the extent of fibrous tissue in the substantia propria.Results Trachoma specimens showed greater numbers of inflammatory cells than control specimens. The expression of cytokines was absent in the normal conjunctiva. Cytoplasmic IL-1 alpha and IL-1 beta expression was noted in the conjunctival epithelium in all trachoma specimens. IL-1 alpha, IL-1 beta, TNF-alpha and PDGF were detected in macrophages infiltrating the substantia propria. B lymphocytes predominated over T lymphocytes in six trachoma biopsies with fibrosis confined to the deep substantia propria, whereas T lymphocytes predominated over B lymphocytes in three biopsies with more extensive fibrosis. In all trachoma biopsies helper/inducer T lymphocytes outnumbered suppressor/cytotoxic T lymphocytes.Conclusions The upregulated local production of IL-1 alpha, IL-beta, TNF-alpha and PDGF might contribute to conjunctival damage and scarring in trachoma.