Molecular bilogical and immunohistochemical analysis on viral chorioretinitis

本研究旨在建立PCR诊断病毒性葡萄膜炎的方法。我们探讨了PCR检测病毒DNA的特异性与病毒性葡萄膜炎分期的关系。用1型单纯疱疹病毒接种玻璃体诱导实验性葡萄膜炎。水溶液中疱疹病毒抗体滴度在第7天开始升高，在第21 ~ 28天达到峰值，随后下降。仅在第3天用PCR检测到病毒DNA。阳性反应发生率为30%。在对疱疹性眼膜炎患者的PCR研究中，健康患者玻璃体液中检测到病毒DNA的频率高于前房液。即使在无环鸟苷治疗2周后，仍可在玻璃体中检测到病毒DNA。在免疫抑制患者中，PCR比疱疹病毒抗体的Q值更有用。对带状疱疹病毒性葡萄膜炎免疫抑制患者的研究表明，弱免疫反应可改变葡萄膜炎的类型。由于PCR检测病毒DNA的发生率低于Q值检测，因此应综合考虑患者免疫应答和眼内液Q值来评价PCR的意义。在对病毒性葡萄膜炎患者的诊断中，应结合患者的免疫应答对其临床表现和病毒学表现进行评价。

This study was performed to establish the diagnostic method of viral uveitis by using PCR.Weinvestigated the relationship between the specificity of PCR on the detection of viral DNA and the stage of viral uveitis.Experimental uveitis was induced by inoculation of herpes simplex virus type 1 into the vitreous body in rabbits. The titers of antibodies against herpes virus in the aqueous fluid started to increase on the 7th day, showed the peak from the 21th day to the 28th day and then decreased. Viral DNA could be detected only on the 3rd day by using PCR.Its incidence of positive reaction was 30%.In the studies of herpetic rveitis patients using PCR,viral DNA was detected in healthy patients more frequently in vitreous fluid than in anterior chamber fluid. Even after the 2 week acyclovir treatment viral DNA could be detected in the vitreous. In the immunosupressive patients, PCR was more useful than Q value of the antibodies against herpes virus. The study on the immunosuppressive patients of herpes zoster virus uveitis showed that weak immune response could change the type of uveitis.Since the incidence of the detection of viral DNA using PCR was less frequent than that of Q value, the significance of PCR should be evaluated under the consideration of immune response of the patients and Q value of the intra-ocular fluid. In the diagnosis of viral uveitis patients, we should evaluate their clinical findings and virological findings considering their immune response.