自体血管内皮细胞移植替代角膜内皮层的实验研究

Replacement of corneal endothelium with auto-vascular endothelium

目的探讨自体血管内皮细胞(VECs)移植替代角膜内皮层的可行性。方法40只家兔随机分为4组。A组,家兔VECs培养移植于去后弹力层的自体角膜植片内表面;B组,角膜植片去后弹力层后移植回原植床;C组,角膜植片取下后移植回原植床;D组,家兔不做处理。术后观察VECs生长状况及角膜植片透明度,A型超声测其厚度。结果A组角膜植片混浊,1周内最明显,后混浊减轻,2周可见前房。细胞生长良好,部分细胞形状不规则。B组角膜植片混浊且不改善。C、D两组角膜无混浊。结论VECs可替代自体角膜内皮层的屏障功能,维持角膜的透明状态。

Objective The transparency of cornea is maintained by the endothelial cells. Dysfunction of the endothelial cells cause edema of cornea. Corneal transplantation is a therapeutic method to cure this disease but it is limited in clinic application because of the shortness of transplant material and recurrence of rejection. This experiment was taken to explore the possibility of replacement of corneal endothelium with auto vascular endothelium. Methods Forty white rabbits were divided into 4 groups. Vascular endodermis was removed from unilateral jugular vein and cultured and stickled to the cornea implant without endothelium,and then the implant with vascular endodermis was transplanted into recipient bed of cornea in experimental group （group A）. In group B,the cornea implant without endothelium was transplanted into recipient bed of cornea as positive control. The cornea implant with endothelium was transplanted into recipient bed of cornea as sham surgery group （ group C）. The rabbits with normal corneas were assigned to group D （ blank control group）. The statues of graft and endothelium were examined under the slim lamp each day after corneal transplantation. Results Isolated and cultured vascular endothelial cells showed positive reaction for Ⅷ factor relevant antigen, presenting the brown-yellow staining in cytoplasm and around nuclear and no positive reaction was seen in blank control group. Cornea was more transparent in group A compared with group B, and the thickness of the cornea graft in group A was thinner than that in group B in the 2 nd week. Well-adhered vascular endothelium was seen in recipient bed of cornea. Conclusion Vascular cndothelium can be used to replace cornea endothelium, and transplanted vascular endothelium exerts a barrier function.