Regulation of the Inflammatory Component in Chronic Dry Eye Disease by the Eye-Associated Lymphoid Tissue (EALT)
Regulation of the Inflammatory Component in Chronic Dry Eye Disease by the Eye-Associated Lymphoid Tissue (EALT)
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DOI：
10.1159/000315017
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Knop, Erich
中科院分区：
文献类型：
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作者：
Knop, Nadja;Knop, Erich
目的：眼表面生理保护性粘膜免疫系统由淋巴细胞、副白细胞和可溶性免疫调节剂组成。在炎症性眼表疾病中也观察到了它们的参与，包括干眼综合征，我们试图在这里描述它们的相互作用。方法：结合现有的有关黏膜免疫和炎症性眼表疾病的文献，讨论我们自己关于人类眼表粘膜免疫系统的结果。结果：眼表本身的粘膜(结膜和角膜)与其粘膜附件(泪腺和泪液引流系统)在解剖上是连续的，并含有一种称为眼相关淋巴组织(ELAT)的粘膜免疫系统。它从泪腺周围的淋巴组织沿着排泄管延伸到结膜相关淋巴组织(CALT)，并进一步进入泪道引流相关淋巴组织(LDALT)。在CALT和LDALT中，ELAT由连续弥漫的淋巴样效应组织和散布的毛囊组成，用于产生效应细胞。眼表疾病的典型事件包括上皮细胞的改变和激活，上皮细胞完整性的丧失，炎性细胞因子的产生，以及可能出现的非致病性和自身抗原-导致免疫耐受性的丧失。文中解释、讨论并通过示意图直观地描述了在生理保护性ELAT的解除管制中发生的事件、由此产生的恶性循环，以及最终自我传播的免疫调节的炎症疾病过程。结论：如果自然代偿因子的能力被推翻，如果疾病不受及时诊断和治疗的限制，解除对ELAT的调控可以协调一个自我传播性炎性粘膜疾病的过程。版权所有(C)2010 S.Karger AG，巴塞尔
Purpose: The physiologically protective mucosal immune system of the ocular surface consists of lymphocytes, accessory leukocytes and soluble immune modulators. Their involvement has also been observed in inflammatory ocular surface diseases, including dry eye syndrome, and we have attempted here to describe their interaction. Methods: Our own results regarding the mucosal immune system of the human ocular surface are discussed together with the available literature on mucosal immunity and inflammatory ocular surface disease. Results: The mucosa of the ocular surface proper (conjunctiva and cornea) is anatomically continuous with its mucosal adnexa (the lacrimal gland and lacrimal drainage system) and contains a mucosal immune system termed 'eye-associated lymphoid tissue' (EALT). This extends from the periacinar lacrimal-gland-associated lymphoid tissue along the excretory ducts into the conjunctiva-associated lymphoid tissue (CALT) and further into the lacrimal drainage-associated lymphoid tissue (LDALT). EALT consists of continuous diffuse lymphoid effector tissue and of interspersed follicles for effector cell generation in CALT and LDALT. Typical events in ocular surface disease include alteration and activation of epithelial cells with loss of epithelial integrity, production of inflammatory cytokines, and potential presentation of non-pathogenic and,self-antigens - leading to a loss of immune tolerance. Events in the deregulation of physiologically protective EALT, resulting vicious circles, and eventual self-propagating immunomodulated inflammatory disease processes are explained, discussed and visualized by schematic drawings. Conclusion: Deregulation of EALT can orchestrate a self-propagating inflammatory mucosal disease process if the capacity of natural compensatory factors is overridden and if the disease is not limited by timely diagnosis and therapy. Copyright (C) 2010 S. Karger AG, Basel