Expression of sodium iodide symporter in the lacrimal drainage system:: Implication for the mechanism underlying nasolacrimal duct obstruction in I131-treated patients
Expression of sodium iodide symporter in the lacrimal drainage system:: Implication for the mechanism underlying nasolacrimal duct obstruction in I131-treated patients
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DOI：
10.1097/01.iop.0000179369.75569.a8
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发表时间：
2005-09-01
影响因子：
2
通讯作者：
Jhiang, Sissy M.
中科院分区：
文献类型：
--
作者：
Morgenstern, Kenneth E.;Vadysirisack, Douangsone D.;Jhiang, Sissy M.
目的：鼻泪道流出道阻塞与高剂量（>150 mCi）放射性碘（1131）治疗有关。 1131 通常用于甲状腺癌治疗，通过 Na+/I 同向转运体 (NIS) 在目标组织中有效转运。我们假设 NIS 在泪囊和鼻泪管中表达，并且 1131 的主动积累是这些患者中所见临床观察结果的原因。方法：使用逆转录酶聚合酶链反应和免疫组织化学分析来评估存档和新鲜人体组织中的 NIS 表达结果：逆转录酶聚合酶链反应分析显示 NIS mRNA 存在于泪囊中。免疫组织化学分析表明NIS蛋白在泪囊和鼻泪管的复层柱状上皮细胞中表达。在泪腺、Wolfring 腺和 Krause 腺、结膜、泪小管和鼻粘膜中未检测到 NIS 蛋白。接受 I-131 治疗的接受泪囊鼻腔吻合术的患者的泪囊中不存在表达 NIS 的柱状上皮细胞，且纤维化明显。结论：NIS 存在于人类泪囊和鼻泪管中，与接受大于 150 mCi I-131 治疗的患者中出现的临床阻塞的解剖区域相关。这表明 NIS 可能是辐射引起的泪道系统损伤的载体。据我们所知，这是鼻泪液流出系统中任何离子转运蛋白的第一份报告，并提出了关于泪囊在眼泪修饰和泪液流出病理学中所起的作用的新问题。
Purpose: Nasolacrimal outflow obstruction has been associated with high-dose (>150 mCi) radioactive iodine (1131) treatment. Commonly used for thyroid cancer treatment, 1131 is effectively transported in the targeted tissue by the Na+/I symporter (NIS). We hypothesized that NIS is expressed in the lacrimal sac and nasolacrimal duct and that active accumulation of 1131 is responsible for the clinical observations seen in these patientsMethods: Reverse transcriptase-polymerase chain reaction and immunohistochemical analyses were used to evaluate NIS expression in both archived and fresh human tissuesResults: Reverse transcriptase-polymerase chain reaction analysis showed that NIS mRNA is present in the lacrimal sac. Immunohistochemical analysis indicated that NIS protein is expressed in the stratified columnar epithelial cells of the lacrimal sac and nasolacrimal duct. NIS protein was undetectable in the lacrimal gland, Wolfring and Krause glands, conjunctiva, canaliculus, and nasal mucosa. NIS-expressing columnar epithelial cells were absent and fibrosis was evident in the lacrimal sacs from I-131-treated patients undergoing dacryocystorhinostomyConclusions: NIS is present in the lacrimal sac and nasolacrimal duct of humans, correlating to the anatomic areas of clinical obstruction that develop in patients treated with greater than 150 mCi of I-131. This suggests that NIS may be the vector of radiation-induced injury to the lacrimal system. To our knowledge, this is the first report of any ion transporter in the nasolacrimal outflow system and raises new questions as to the role the lacrimal sac plays in the modification of tears and in lacrimal outflow pathology.