抗视网膜抗体及其在自身免疫性视网膜病变中的作用

Anti-retinal antibodies and their role in autoimmune retinopathy

自身免疫性视网膜病变(AIR)是一类免疫介导的视网膜病变,通常会造成视力严重丧失及视野缺损。AIR主要包括副肿瘤综合征及非副肿瘤综合征,其主要特征之一就是存在外周循环抗视网膜抗体(ARAs)。外周循环ARAs分别通过抗肿瘤反应、抗微生物反应以及视网膜受损伤后产生的自身抗原碎片诱导的免疫反应而产生,主要攻击视网膜光感受器细胞。ARAs对于AIR的诊断、进展及治疗效果评估都有重要意义。同时这些ARAs经常出现在癌症诊断之前,有利于恶性肿瘤的早期发现。本文就ARAs的产生机制、在AIR中的病理作用及在临床中的意义进行综述。

Autoimmune retinopathy(AIR)is a group of immune-mediated retinopathies that usually results in severe loss of vision and visual field defects.AIR mainly includes paraneoplastic and non-paraneoplastic syndromes.One main feature of AIR is the presence of circulating anti-retinal antibodies(ARAs)in peripheral blood,which are produced through anti-tumor responses,anti-microbial responses,and immune responses induced by autoantigen fragments following retinal injury,and mainly attack retinal photoreceptor cells.ARAs are important for the diagnosis,progression assessment and treatment outcome of AIR.These ARAs often appear before the diagnosis of cancer and can be helpful for the early detection of malignant tumors.The mechanism of ARAs production,its pathological role in AIR,and its significance in clinical practice were reviewed in this article.