Immunological effects of the vitreous on ocular inflammatory condition

目的：探讨玻璃体对内窥镜的影响。比较了活动性葡萄膜炎患者与非活动性葡萄膜炎患者及伴有特发性黄斑孔或视网膜前膜的非葡萄膜炎患者玻璃体液中各种炎症介质的浓度，特别是葡萄膜酸。ELISA法检测的炎症介质如下：细胞因子、趋化因子、可溶性粘附分子、可溶性受体分子及其配体。本研究涉及的葡萄球菌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，后者不是真正的炎症，而是最初的恶性肿瘤。我们还利用实验性自身免疫性葡萄膜视网膜炎（EAU）大鼠模型，研究了Fas、Fas配体在眼驻留细胞和浸润细胞表面表达的时间过程，以了解玻璃体本身是否具有与前房作用相同的对眼浸润炎性细胞诱导凋亡的潜在作用。在活动性葡萄膜炎的玻璃体标本中，各种炎症介质如IL-6、IL-8、IFN-γ、sTNF-R1、2、MIF、mmp -1β、sFas、sFas配体、sICAM-1和s-选择素等与非活动性葡萄膜炎和非炎症性眼病相比显著升高。在活动性葡萄膜炎中，玻璃体中产生的各种细胞因子的表达模式随疾病的不同而不同。例如，IL-6、IL-10和IFN-γ在ARNS中升高，IFN-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，从葡萄膜炎和非葡萄膜炎患者获得的玻璃体液均诱导眼浸润性T细胞凋亡。在发生EAU的眼玻璃体中，凋亡T细胞与睫状体上Fas配体的表达同时出现。这些数据表明，活动性葡萄膜炎的玻璃体液中有多种介质与眼内炎症的调节有关。玻璃体被认为是各种炎症介质和抗原的储存库，玻璃体切除术似乎可以通过排除玻璃体来减少炎症活动。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