In Vivo Confocal Microscopy of Conjunctiva-Associated Lymphoid Tissue in Healthy Humans
In Vivo Confocal Microscopy of Conjunctiva-Associated Lymphoid Tissue in Healthy Humans
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DOI：
10.1167/iovs.14-14365
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发表时间：
2014-08-01
影响因子：
4.4
通讯作者：
Mastropasqua, Leonardo
中科院分区：
文献类型：
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作者：
Agnifili, Luca;Mastropasqua, Rodolfo;Mastropasqua, Leonardo
目的.采用激光扫描共聚焦显微镜（IVCM）研究健康人结膜相关淋巴组织（CALT）的存在、分布和形态特征随年龄的变化。共入组108例（年龄范围：17-75岁）受试者。在体内共聚焦显微镜下观察睑板和球结膜，并进行印迹细胞学（IC）和CD 3（上皮内T淋巴细胞）和CD 20（上皮内B淋巴细胞）抗体免疫荧光染色。主要结果为上皮下淋巴细胞密度（LyD）、滤泡密度（FD）和滤泡面积（FA）。次要结果是卵泡反射率（FR）、淋巴细胞密度（FLyD）、CD 3和CD 20阳性。在所有受试者中均观察到结膜相关淋巴组织（仅上级为97%，上级和下睑板均为3%）。淋巴细胞密度范围为7.8至165.8个细胞/mm（2）（46.42 [18.37];平均值[SD]），FD范围为0.5至19.4个卵泡/mm（2）（5.3 [3.6]），FA范围为1110至96，280 mm（2）（26，440 [26，280]）。所有三个参数均与年龄呈高度显著的反立方关系（P < 0.001）;也就是说，在第一个和最后一个参数中，35岁和65岁以上的年龄急剧下降，在这些年龄之间存在平台期，而FA在研究的年龄范围内的损失率逐渐降低。CD 3、CD 20 IC与上述结果一致。在体内共聚焦显微镜是有效地揭示CALT和修改这些结构经历老化。年龄相关的所有参数定义淋巴结构的退化。这些改变可能是老年人眼粘膜免疫功能下降和眼表疾病增加的原因。
PURPOSE. To investigate modifications with aging of the presence, distribution and morphologic features of conjunctiva-associated lymphoid tissue (CALT) in healthy human subjects using laser scanning in vivo confocal microscopy (IVCM).METHODS. A total of 108 (age range, 17-75 years) subjects were enrolled. In vivo confocal microscopy of the tarsal and bulbar conjunctiva, and impression cytology (IC) with CD3 (intra-epithelial T-lymphocytes) and CD20 (intra-epithelial B-lymphocytes) antibody immunofluorescence staining were performed. The main outcomes were subepithelial lymphocyte density (LyD), follicular density (FD), and follicular area (FA). The secondary outcomes were follicular reflectivity (FR), and lymphocyte density (FLyD), and CD3 and CD20 positivity.RESULTS. Conjunctiva-associated lymphoid tissue was observed in all subjects (97% only superior and 3% in both superior and inferior tarsum). Lymphocyte density ranged from 7.8 to 165.8 cells/mm(2) (46.42 [18.37]; mean [SD]), FD from 0.5 to 19.4 follicles/mm(2) (5.3 [3.6]), and FA from 1110 to 96,280 mm(2) (26,440 [26,280]). All three parameters showed a highly significant inverse cubic relationship with age (P < 0.001); that is, in the first and last parameters a steep decline up to 35 years and above 65 years of age, with a plateau phase between these ages, whereas FA had a gradually decreasing rate of loss over the studied age range. CD3 and CD20 IC were consistent with these results.CONCLUSIONS. In vivo confocal microscopy was effective in revealing CALT and modifications these structures undergo with aging. Aging correlated with an involution of all parameters defining lymphoid structures. These modifications may account for the decrease of mucosal immune response and increase of ocular surface diseases in the elderly.