Corneal lymphangiogenesis - Evidence, mechanisms, and implications for corneal transplant immunology
Corneal lymphangiogenesis - Evidence, mechanisms, and implications for corneal transplant immunology
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DOI：
10.1097/00003226-200304000-00021
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发表时间：
2003-04-01
期刊：
影响因子：
2.8
通讯作者：
Streilein, JW
中科院分区：
文献类型：
--
作者：
Cursiefen, C;Chen, L;Streilein, JW
目的。正常的角膜没有血管和淋巴管，但由于各种角膜疾病和外科手术，可继发形成血管化。角膜新生血管，即从原有的角膜缘血管中长出的新生血管，在临床和组织学上都是显而易见的，但长期以来，相关的角膜淋巴管生成的证据由于不可见性和缺乏特异性标记物而受到阻碍。这种情况随着最近发现的淋巴管内皮标记物血管内皮生长因子受体3、LYVE-1(一种淋巴管内皮细胞特异性透明质酸受体)、Prox 1和泊多拉宁的发现而改变。方法：研究方法。在此，我们总结目前关于角膜淋巴管生成的证据，并描述其分子标志物和介体。此外，还讨论了角膜淋巴管生成对角膜移植免疫学的病理生理学意义。结果。血管高危病床上的角膜血管生成为免疫效应细胞进入移植物提供了途径，而淋巴管生成使抗原提呈细胞和抗原物质从移植物排出到区域淋巴结，从而诱导同种异体免疫和随后的移植物排斥反应。结论。在角膜移植的高风险和低风险环境下，抗淋巴管生成策略可能会提高移植存活率。
Purpose. The normal cornea is devoid of blood and lymphatic vessels but can become vascularized secondary to a variety of corneal diseases and surgical manipulations. Whereas corneal (hem)angiogenesis, i.e., the outgrowth of new blood vessels from preexisting limbal vessels, is obvious both clinically and histologically, proof of associated corneal lymphangiogenesis has long been hampered by invisibility and lack of specific markers. This has changed with the recent discovery of the lymphatic endothelial markers vascular endothelial growth factor receptor 3, LYVE-1 (a lymphatic endothelium-specific hyaluronan receptor), Prox 1, and Podoplanin. Methods. We herein summarize the current evidence for lymphangiogenesis in the cornea and describe its molecular markers and mediators. Furthermore, the pathophysiologic implications of corneal lymphangiogenesis for corneal transplant immunology are discussed. Results. Whereas corneal angiogenesis in vascularized high-risk beds provides a route of entry for immune effector cells to the graft, lymphangiogenesis enables the exit of antigen-presenting cells and antigenic material from the graft to regional lymph nodes, thus inducing alloimmunization and subsequent graft rejection. Conclusions. Antilymphangiogenic strategies may improve transplant survival both in the high- and low-risk setting of corneal transplantation.