免疫介导炎症在干眼发病机制中的作用

Role of immune-mediated inflammation in the pathogenesis of dry eye

干眼是一种泪膜稳定性降低和眼表功能损害的多因素疾病,可伴有泪液渗透压升高及眼表炎症反应。最新研究认为,眼表保护性免疫调节机制破坏及过度炎症反应在干眼发病中起着关键作用。免疫介导炎症相关机制已成为近年研究的热点。炎症和干眼可互为因果,相互促进,最终形成恶性循环,造成眼表结构和功能的持续性损害。控制眼表炎症及打破炎性循环是干眼治疗的重要环节。本文主要归纳总结了眼表的免疫调节机制,并针对免疫介导炎症在干眼发病中的最新研究进展进行综述,包括自然杀伤细胞激活、Toll样受体激活、促炎细胞因子和趋化因子分泌、角膜抗原呈递细胞活化和成熟、T细胞介导的免疫炎症反应等。此外,本文列举了干眼炎症通路中的重要环节和关键机制,以期为减轻炎症所致眼表损害及改善干眼症状提供潜在的治疗靶点。

Dry eye is a multi-factorial disease characterized by reduced tear film stability and ocular surface damage,accompanied by tear hyperosmolarity and ocular surface inflammation.Recent studies suggest that the disruption of protective immune regulation of the ocular surface and imbalance of inflammatory response play a key role in the pathogenesis of dry eye.Immune-mediated inflammation in dry eye has become a hot topic in recent years.Inflammation and dry eye can cause and promote each other,and eventually form a vicious inflammatory cycle,which can result in a constant damage to the normal structure and function of the ocular surface.Suppressing the ocular surface inflammation and breaking the vicious inflammatory cycle are key points in dry eye treatment.This article summarized the immune regulation of ocular surface,and reviewed the recent research progress of immune-mediated inflammation in the pathogenesis of dry eye,including the activation of natural killer cells,the activation of Toll-like receptors,the secretion of pro-inflammatory cytokines and chemokines,the activation and maturation of corneal antigen presenting cells,the immune inflammatory response mediated by T cells,etc.This article listed the crucial parts and vital mechanisms of immune-mediated inflammation in dry eye to provide potential therapeutic targets for alleviating the ocular surface damages and discomforts caused by dry eye.