CORTICOSTEROID HYPERSENSlTIVITY IN THE UVEITIS TREATMENT AND MOLECULAR BIOLOGICAL BACKGROUND

我们对12例Vogt-Koyanagi-Harada病患者淋巴细胞采用早期活化抗原CD69 ELISA检测皮质类固醇的敏感性。结果表明，VKH病的临床病程与淋巴细胞对皮质类固醇的敏感性有关。在日本，白塞病患者全身服用类固醇后，眼部症状往往会恶化。测定了7例白塞病患者眼内手术后给予类固醇的敏感性。其中3/7为低类固醇敏感性，该组术后炎症发作频率和眼压均高于4例高类固醇敏感性患者。日本白塞病患者在服用皮质类固醇后眼部症状恶化。这种现象在西方患者中没有观察到。1951年到1974年间，日本法律要求每年接种卡介苗。接种在一些欧洲国家进行。本研究旨在阐明卡介苗与皮质类固醇敏感性之间的关系。每周给大鼠接种1 mg卡介苗，直至足垫反应呈阳性。15周龄时，脾细胞与PHA和倍他米松混合培养24小时。采用实时PCR法检测白细胞介素2 RNA基因。Lewis大鼠il - 2基因表达未被类固醇抑制。在WAKH大鼠中，敏感性由接种卡介苗后的敏感性改变，添加类固醇后IL2基因表达增加。BCG被认为是影响敏感性的一个因素。

We evaluated the sensitivity for corticosteroids in 12 cases of Vogt-Koyanagi-Harada disease using the cell surface of early activated antigen CD69 ELISA test on lymphocytes. The results showed the clinical course of VKH disease is dependent on the sursceptibility of lymphocytes to corticosterpoid in each patients. Systemic administration of steroids to patients with Behcet's disease in Japan is often followed by a worsening in ocular symptoms. The sensitivity of 7 patients with Behcet's disease to steroids which were administrered after intraocular surgery was measured. 3/7 showed a low steroids sensitivity, and the frequency of postoperative inflammatory episodes and the intraocular pressure were both higher for this group than for the 4 who showed high steroid sensitivity. Ocular symptoms deteriorate in Japanese patients with Behcet's disease after administration of corticosteroids. This phenomenon is not observed in Western patients. Between '51 and '74, the Law in Japan required BCG vaccine every year. Inoculation is performed in a few European countries. Study was conducted to clarify the relationship between BCG and corticosteroid sensitivity. Rats were inoculated with 1 mg of BCG every week until a foot pad reaction became positive. At the age of 15 weeks, spleen cells were cultured with a mixture of PHA and betamethasone for 24 hours. Interleukin 2 RNA gene was measured using a real-time PCR.. IL2 gene expression was not suppressed by steroids in Lewis rats. In WAKH rats, sensitivity changed from sensitive after BCG inoculation and IL2 gene expression increased after the addition of steroids. BCG was considered to be a factor affecting sensitivity.