Immunological effects of the vitreous on ocular inflammatory condition

为探讨玻璃体在眼内炎症尤其是葡萄膜炎中的作用，比较了活动期葡萄膜炎患者、非活动期葡萄膜炎患者和伴有特发性黄斑裂孔或视网膜前膜的非葡萄膜炎患者玻璃体中各种炎症介质的浓度。用ELISA法测定的炎症介质有：细胞因子、趋化因子、可溶性黏附分子、可溶性受体分子及其配体。本研究涉及的葡萄膜炎包括急性视网膜坏死综合征(ARNS)、巨细胞病毒性视网膜炎、结节病和原发性眼内淋巴瘤，它们不是真正的炎症，而是起源于恶性的。通过建立实验性自身免疫性葡萄膜视网膜炎(Eau)大鼠模型，研究了玻璃体本身是否具有潜在的…作用，观察了眼球停留细胞和浸润性细胞表面Fas、Fas配体的表达时程。对眼内浸润性炎症细胞的作用更强，诱导细胞凋亡的作用与前房相同。在活动期葡萄膜炎患者的玻璃体标本中，IL-6、IL-8、干扰素-γ、sTNF-R1、2、MIF、MIP-1β、sFas、sFas配体、sICAM-1、S-选择素等多种炎性介质水平明显高于非活动期葡萄膜炎组和非炎症性眼病组。在活动期葡萄膜炎中，玻璃体产生的各种细胞因子的表达模式因疾病的不同而不同。如IL-6、IL-10和干扰素-γ在ARNS中升高，干扰素-γ在结节病中升高，IL-10在原发性眼内淋巴瘤中升高。有趣的是，葡萄膜炎患者和非葡萄膜炎患者的玻璃体积液均可诱导眼部浸润性T细胞发生凋亡。在发展为EAU的眼玻璃体中，凋亡的T细胞与睫状体Fas配体的表达同时出现。提示活动期葡萄膜炎玻璃体积液中存在多种与眼内炎症调节有关的介质。对于葡萄膜炎眼，玻璃体切割术似乎可以通过排除玻璃体而减少炎症活动，因为玻璃体被认为是各种炎症介质和抗原的储存库。较少

To investigate the effect of the vitreous body on the intr.rtocu1ar inflammatory disorders, especially uveitides, the concentrations of various kinds of inflammatory mediators in the vitreous fluids of active uveitis patients were compared with that of non-active uveitis patients and none-uveitis patients with either idiopathic macu1ar hole or epiretinal membrane. Inflammatory mediators measured by ELISA assay were as follows; cytokine, chemokine, soluble adhesion molecules, soluble receptor molecules and their ligands. Uveitides involved in this study, consisted from acute retinal necrosis syndrome (ARNS), cytomegalovirus retinitis, sarcoidosis and primary intraocular lymphoma, which is not true inflammation but originally malignancy. We also studied the time-course of the expression of Fas, Fas ligand on the surface of ocular resident cells and infiltrating cells using the rat model of experimental autoimmune uveoretinitis (EAU) to know whether vitreous body itself has a potential ef … More fect on ocular infiltrating inflammatory cells to be induced apoptosis in the same way as the effect of anterior chamber. In the vitreous specimen of the active uveitis, various inflammatory mediators such as, IL-6, IL-8, IFN-γ, sTNF-R1, 2, MIF,MIP-1β, sFas, sFas ligand, sICAM-1 and s-selectin significantly increased compared to the non-active uveitides and none inflammatory ocular disease. In the active uveitis, expression pattern of various cytokines produced in the vitreous body were different in accordance with the diseases. For example, IL-6, IL-10 and IFN-γ increased in ARNS, IFN-γ in sarcoidosis, IL-10 in primary intraocular lymphoma. Interestingly, the vitreous fluid obtained from both uveitis and none-uveitis patients induced apoptosis on ocular infiltrating T cells. In the vitreous body of the eye developed EAU, apoptotic T cells appeared at the same time with the expression of Fas ligand on ciliary body. These data demonstrated that there are various kinds of mediators in the vitreous fluid of the active uveitis related to modulation of intraocular inflammation. It seemed that the vitrectomy for the eye with uveitis may reduce the inflammatory activity by excluding the vitreous body where is considered to be a reservoir of various kind of inflammatory mediators and antigens. Less