目的通过检测SJS／TEN患者急性期结膜上皮细胞人类白细胞抗原DR（human leukocyte antigen—DR，HLA—DR）的表达，探讨局部HLA—DR表达与SJS／TEN患者眼部损伤以及疾病严重程度的相关性，以进一步探讨HLA—DR抗原在SJS／TEN发病中的作用。方法收集临床确诊的sJs和TEN急性期患者，同一时间采用SCORTEN评分系统进行疾病严重程度评分（severity of illness score，SIS），根据结膜充血、结膜渗出、结膜假膜、角膜糜烂、眼睑累及和睑缘累及6个方面进行眼部损伤程度评分（severity of eye score，SES），通过结膜印迹细胞学方法获取球结膜上皮细胞，应用流式细胞术检测球结膜上皮细胞中HLA—DR的表达，并分析各指标间的相关性。结果SJS和TEN急性期患者共8例，SIS平均为n=8，（1．25±1．83）分，SES平均为17=16，（7．38±3．48）分，结膜上皮细胞HLA—DR的表达量为n=16，（35．25±12．30）％。相关分析发现，SES和双眼结膜上皮细胞HLA—DR的表达量的平均值成正相关（n=16，r=0．739，P=0．001）；双眼SES和SIS无相关（n=8，r=0．626，P=0．097）；SIS和双眼结膜上皮细胞HLA—DR的表达量的平均值无相关（n=8，r=0．600，P=0．116）。结论在SJS／TEN急性期眼部损伤的发生过程中，存在HLA—DR介导的结膜上皮细胞作为非特异性抗原递呈细胞的激活状态，眼部损伤和疾病的严重程度具有不同步性，在急性期应同时进行眼部损伤评分，根据评分采取相应的眼部治疗，减少并发症的发生。
AIM：To compare the corneal biomechanics of Sj？gren＇s syndrome（SS） and non-SS dry eyes with Corneal Visualization Scheimpflug Technology（CorV is ST）.METHODS：Corneal biomechanics and tear film parameters, namely the Schirmer I test value, tear film break-up time（TBUT） and corneal staining score（CSS） were detected in 34 eyes of 34 dry eye patients with SS（SSDE group） and 34 dry eye subjects without SS（NSSDE group） using CorV is ST. The differences of the above parameters between the two groups were examined, and the relationship between corneal biomechanics and tear film parameters were observed. RESULTS：The differences in age, sex, intraocular pressure（IOP） and central corneal thickness（CCT） were not significant between the two groups（P〉0.05）. The tear film parameters had significant differences between the SSDE group and NSSDE group（all P〈0.05）. Patients in the SSDE group had significantly lower A1-time and HC-time, but higher DA（P=0.01, 0.02, and 0.02, respectively） compared with the NSSDE group. In the SSDE group, DA was negatively correlated with TBUT（rho=-0.38, P=0.03）; HC-time was negatively correlated with CSS（rho=-0.43, P=0.02）. In the NSSDE group, HC-time was again negatively correlated with CSS（rho=-0.39, P=0.02）.CONCLUSION：There are differences in corneal biomechanical properties between SSDE and NSSDE. The cornea of SSDE tends to show less ＂stiffness＂, as seen by a significantly shorter A1-time and HC-time, but larger DA, compared with the cornea of NSSDE. Biomechanical parameters can be influenced by different tear film parameters in both groups.
· AIM: To investigate the expression of complement factors in the posterior scleral fibroblasts of guinea pigs with negative lens-defocused myopia.· METHODS: Eighteen guinea pigs were assigned randomly to two groups: the negative lens-defocused group(NLD group, n =9) and the normal control without treatment group(NC group, n =9). The effect of myopic induction was compared in three subgroups: eyes treated with a-10.00 D negative lens in the NLD group(NL group), eyes treated with a plano(0 D) lens in the NLD group(PL group), and untreated right eyes in the NC group(NC group). The following analyses were conducted at four weeks: examination of the refractive error via retinoscopy, assessment of complement C5b-9expression in the posterior scleral fibroblasts using immunohistochemistry, and measurements of complement C1 q and C3 protein levels in the posterior sclera by Western blot.·RESULTS: After an induction period of four weeks, a significant myopic shift was detected in the eyes of the NL group, relative to that of the PL and NC groups(P <0.05). Data analysis showed a significant increase in the percentage of C5b-9 immunopositive fibroblasts in the posterior sclera of the NL group eyes, compared to the PL group(q =11.50, P <0.001). Significantly higher levels of C1q(q =4.94, P =0.01) and C3(q =4.07, P =0.03)protein were detected in the posterior sclera of NL group eyes, compared to the PL group. There were no significant difference between the PL and NC groups for C5b-9(q =2.44, P =0.10), C1q(q =1.55, P =0.53) and C3(q =0.98, P =0.77) in the posterior sclera.·CONCLUSION: The data from present study provide evidence of the up-regulation of C5b-9, C1 q and C3 in the posterior scleral fibroblasts in a NLD myopic animal model. The results suggest that the complement system may be involved in the development of myopia.
