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Research on underlying mechanisms of Stevens-Johnson syndrome

史蒂文斯-约翰逊综合征的潜在机制研究

基本信息

批准号：
17390470
负责人：
SOTOZONO Chie
金额：
$ 9.92万
依托单位：
Kyoto Prefectural University of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

项目摘要

1. We enrolled 73 patients (138 eyes) with Stevens-Johnson syndrome at chronic stage. Complications were categorized as corneal-, conjunctival-, and eyelid complications and 13 components were evaluated and graded on a scale from 0 to 3 according to their severity. The most severe complication components were loss of the palisades of Vogt (114 eyes, 82.6%) and meibomian gland involvement (102 eyes, 73.9%). Visual acuity in 74 of the 138 eyes (53.6 %) was worse than 20/200. Multivariable regression analysis showed that corneal neovascularization, opacification, keratinization, and cataracts significantly affected logMAR (p<0.0001, p<0.0001, p=0.0142, and p=0.0375, respectively). 2. We examined the histocompatibility antigen genes HLA-A,-B, and-C of 40 Japanese SJS/TEN patients with ocular complications and 113 healthy Japanese volunteers. We clarified that HLA-A*0206 is strongly associated with SJS/TEN with ocular complications in the Japanese. 3. The Japanese single-nucleotide-polymorphism (JSNP) database reports 7 polymorphisms consisting of 7 SNPs in the human Toll-like receptor (TLR) 3 gene ; 3 of the 7 SNPs are coded in exon regions, and the other 4 are coded in intron regions. These 7 SNPs were analysed in 57 Japanese patients with SJS/TEN with ocular surface complications and in 160 Japanese healthy controls. SNP 299698T/G and the genotype patterns of 293248A/A and 299698T/T were strongly associated with SJS/TEN. The results suggested that polymorphisms in the TLR3 gene could be associated with SJS/TEN in the Japanese population. 4. We found that bacterial strains not only from different subjects but also from multiple ocular surface sites of the same subject exhibited different PFGE patterns. The data demonstrated the polyclonality of S. epidermidis on the healthy ocular surface.

1.我们纳入了73例（138只眼）慢性期Stevens-Johnson综合征患者。并发症分为角膜、结膜和眼睑并发症，对13个组成部分进行了评价，并根据其严重程度在0 - 3级量表上进行分级。最严重的并发症是沃格特栅栏丧失（114眼，82.6%）和睑板腺受累（102眼，73.9%）。138只眼中74只眼（53.6%）视力低于20/200。多变量回归分析显示，角膜新生血管形成、混浊、角化和白内障显著影响logMAR（分别为p<0.0001、p<0.0001、p=0.0142和p=0.0375）。2.我们检测了40名日本SJS/TEN眼部并发症患者和113名日本健康志愿者的组织相容性抗原基因HLA-A、-B和-C。我们阐明了HLA-A*0206与日本人的SJS/TEN眼部并发症密切相关。3.日本单核苷酸多态性（JSNP）数据库报告了人类Toll样受体（TLR）3基因中由7个SNP组成的7种多态性; 7个SNP中的3个编码在外显子区域，另外4个编码在内含子区域。在57例有眼表并发症的SJS/TEN日本患者和160例日本健康对照中分析了这7个SNP。SNP 299698 T/G和293248 A/A、299698 T/T基因型与SJS/TEN密切相关。结果表明，TLR 3基因多态性可能与日本人群中的SJS/TEN相关。4.我们发现，细菌菌株不仅从不同的主题，而且从多个眼表部位的同一主题表现出不同的PFGE模式。结果表明，S.健康眼表的表皮。