甲状腺相关性眼病眼外肌免疫细胞的研究

Infiltration of immunuocytes in extraocular muscles of thyroid associated ophthalmopathy

目的研究甲状腺相关性眼病(TAO)眼外肌中免疫细胞的分布,探讨TAO的发病基础。方法标本取自TAO受累眼外肌,对照组取自正常眼外肌组织,免疫组织化学染色法分析TAO受累眼外肌中巨噬细胞、HLA-DR阳性细胞、T淋巴细胞亚群和B淋巴细胞的分布和活性。结果TAO受累眼外肌中包含大量巨噬细胞、HLA-DR阳性细胞和少量T细胞,缺少B细胞,其中巨噬细胞数明显增多,为正常对照组的2倍(P<0.01),但无面积差异(P>0.05)。TAO受累眼外肌中大部分T细胞为CD4+T细胞,而正常对照组主要为CD8+T细胞。结论TAO受累眼外肌中巨噬细胞等免疫细胞增多。

Objective Thyroid associated ophthalmopathy （TAO） is a kind of immunopathogenic disorder. The immunoeompetent cells may be important mediators in the local pathogensis of TAO. The distribution of immunoeytes in extraoeular muscle （EOM） of eye with TAO was studied to explore the pathogenic mechanism of TAO. Methods Eight EOM specimens were collected from 8 patients with TAO during squint surgeries. The specimens in controls were obtained from healthy corpse eyes. The cell distributions of immunoeytes, including maerophages, HLA-DR positive cells, T cells and B cells were analyzed quantitatively using SP immunohistoehemieal method. Results Abundant maerophages,HLA-DR positive cells and T cells were found in extraoeular muscle of TAO. Whereas B cells were absent in all specimens. There was a significant increase in maerophages in TAO compared with the eontrol（P 〈 0. 01 ）. In extraoeular muscle of TAO, maerophages were more two times than control tissues （97 ± 10. 15/mm^2 in TAO ,48 ±7.17/mm^2 in control）. CD4^＋ T cells with brown color in cytoplast were evident in TAO specimens and CD8 ^＋ T cells in control tissues. Conclusion Maerophages is probably involved in the pathogenesis of TAO. Early intervention of immunosuppressive therapy of anti-maerophage may influence the sequel caused by extraoeular muscle fibrosis in TAO.