Stevens-Johnson综合征慢性期结膜中Fas-FasL的表达

Conjunctival Fas-FasL expression in chronic Stevens-Johnson syndrome

目的 探讨Fas-FasL通路在Stevens-Johnson综合征（SjS）患者慢性期眼部病变病理机制中的作用.方法 回顾性研究.收集SJS慢性期存在眼部病变的患者14例,在睑球粘连松解术中取结膜组织,病理切片下观察形态学特点,采用免疫组织化学方法（直接免疫荧光染色）评估患者结膜组织中Fas-FasL（CD95/CD178）的表达,并与正常结膜进行对照.结果 结膜组织病理切片可见上皮层增厚和上皮层下空洞样黏液腺泡破坏,SJS组Fas表达多分布于上皮基底层;正常结膜标本Fas表达高于SJS组,在整个上皮层内均匀分布.FasL在SJS组和正常对照组结膜中均微弱表达.结论 SJS患者慢性期结膜组织中Fas-FasL的局部低表达在产生SJS慢性期患者眼部损伤中起到一定的作用.

Objective To investigate the expression level of Fas-FasL in conjunctiva tissue of chronic Stevens-Johnson syndrome （SJS） patients and to analyze the role of Fas-FasL pathway in the mechanism of ocular damage related to SJS.Methods Conjunctiva tissue was obtained during symblepharon release operation and cryostat sectioned at 5 μm.The tissue morphology was observed by electron microscopy.The expression of Fas-FasL （CD95/CD178） in conjunctiva was detected by immunohistochemistry （direct immunofluorescence）.The conjunctiva tissue of normal people was also observed and tested as contrast group.Results The pathogenic changes included incrassation of epithelium and cavity of mucous glands in the sub-epithelium.The expression of Fas in SJS patients focusing in the basal layer of epithelium appeared a lower level compared to that in normal human conjunctiva,which distributed equally in all layers of epithelium.The expressions of FasL in SJS patients and normal people were both weak.Conclusions The low level expression of Fas-FasL in conjunctiva of SJS patients has certain effect on the chronic ocular damage.