基质金属蛋白酶(MMP-3)及其抑制剂(TIMP-2)在长期使用抗青光眼药物的结膜TENON'S囊中的表达

Expression of MMP-3 in conjunctival tenon capsule with long-term atiglaucoma drops

目的研究长期应用眼表抗青光眼药物后人的Tenon's囊的成纤维细胞中基质金属蛋白酶(MMP-3)及其抑制剂(TIMP-2)的表达,以了解长期局部应用抗青光眼药物后结膜下组织的病理改变。方法收集长期应用抗青光眼药物及无长期应用抗青光眼药物在小梁切除术中切除的结膜及结膜下组织各20例(20只眼),进行HE染色和马松染色后,在光镜下观察组织学形态,筛选组织标本,进行免疫组织化学检查。结果两组在年龄、性别、诊断之间无差异。用药组A组:用药时间13年;未用药组B组:用药时间790 d。小梁切除术前用两种抗青光眼药的患者为15例,3种以上的患者为5例,未用抗青光眼药的患者20例,用药1年以上的患者20例。在光镜下观察HE和马松染色显示:长期应用抗青光眼药结膜上皮排列不规则,浅基质层为增生的胶原纤维和大量的新生血管伴有炎细胞浸润。在免疫组织化学染色切片,两种抗体染色阳性细胞浆呈程度不同、基本均色棕黄色粗大颗粒反应,反之则为染色阴性。MMP-3和TIMP-2在A、B两组间的表达有差异,P<0.01,有统计学意义。结论长期应用眼表抗青光眼药物后人的Tenon's囊的成纤维细胞中MMP-3及其TIMP-2的表达异常,其临床意义在于长期应用局部抗青光眼药物可以增加组织的改变和增加滤过手术术后的瘢痕形成。

Objective The purpose of this study is to investigate the histopathology changes of conjunctival tissure and the expression of MMP-3 in conjunctival Tenon capsule with longterm anti-glaucoma eye-drops.Methods 20 Conjunctival speciments with longterm anti-glaucoma eye drop and 20 without longterm anti-galucoma eye drop were took from trabeculectomy procedure,HE and Masson-stained slides were examined by light microscopy,and the expression of matrix metalloproteinase（MMP-3） in conjunctival tissues were examined by immunohistochemistry.Results There are no age and sex differences in two groups,In long-term eye drops group（group A）,time of administration is 1-3 years;In short-term eye drops group（group B,time of administration id 7-90 days,In group A,two kinds of anti-glaucoma eye drops were used in 15 cases and three kinds of antiglaucoma eye drops were used in 5 cases before trabeculectomy.There 20 cases in group B.HE and Masson-stain showed that conjunctival epithelium with long-term antiglaucoma eye drops is irregular with collagens,vessels proliferation,and inflammatory cell infiltration in the superficial substantia propria layer.The MMP-3 positive staining is brown in cytoplasm.MMP-3 positive expression was found in 17 cases（85%）,and negative in 3 cases（15%） in group A.Whereas,MMP-3 positive expression was found in 6（30%）,and negative 14（70%） in group B（P=0.001）.There are significant difference between two groups.（P〈0.01）.Conclusion The increased expression of antibodies against MMP-3 with long term Anti-glaucoma drops in conjunctival Tenon capsule fibroblast cells indicates that long-term Anti-glaucoma drops my increase the changes of conjunctive tissue and scar formation after anti-glaucoma surgery.