我国角膜基础和临床研究的现状及发展

Advances in basic and clinical corneal research

现已公认,角膜上皮干细胞存在于角膜缘基底层.近来研究发现,除角膜缘外,在角膜上皮的基底层细胞还存在着寡能干细胞,同样可以参与上皮细胞的损伤修复.角膜内皮细胞正常在体内不能再生,近来研究发现内皮细胞在特定部位也存在有干细胞,在特定条件下可以转化为内皮细胞.角膜基质细胞同样存在干细胞,并且基质细胞具有异质性,在特定环境下可以表现其神经嵴前体细胞的特性,是HSV-1潜伏感染的基础.真菌性角膜炎不同致病菌种的菌丝在角膜内有不同的生长方式的发现,对推动真菌性角膜炎的手术治疗起了极为重要的作用.我国棘阿米巴角膜炎的主要危险因素是由植物和泥土外伤造成,与国外报道的角膜接触镜是主要危险因素不同,为临床的诊断提供了新的重要信息.在此,将近5年角膜的基础和临床研究进展进行分析.

It is well known that corneal epithelial stem cells reside in the limbal basal layer.Recently, it has been found that oligopotent stem cells, located in the basal layer of corneal epithelium, can repair epithelial cell damage. Although corneal endothelial cells usually could not regenerate in vivo, stem cells have been detected in the endothelial cell layer and can convert into endothelial cells under certain circumstances. Stem cells are also present in corneal stroma. The heterogeneous stromal cells manifest features of neural crest progenitor cells in some situations, which make latent herpes simplex virus-1 infection possible. Moreover, the finding that the hyphal growth of different fungal pathogens shows different patterns in the cornea. This finding significantly promotes the surgical treatment of fungal keratitis. The major risk factor of acanthamoeba keratitis in China is trauma caused by plants or soil, which is different from developed countries, in which the major risk factor is contact lens wear. This finding provides important new information for clinical diagnosis of this disorder. Advances in basic and clinical corneal research in the last five years are reviewed in this article.