目的研究B、T淋巴细胞衰减因子(B and T lymphocyte attenuator,BTLA)及其配体疱疹病毒侵入介体(herpes virus entry mediator,HVEM)在单纯疱疹性角膜基质炎(herpetic stromal keratitis,HSK)小鼠角膜组织中及外周血CD4+T细胞上的表达水...目的研究B、T淋巴细胞衰减因子(B and T lymphocyte attenuator,BTLA)及其配体疱疹病毒侵入介体(herpes virus entry mediator,HVEM)在单纯疱疹性角膜基质炎(herpetic stromal keratitis,HSK)小鼠角膜组织中及外周血CD4+T细胞上的表达水平,探讨共抑制信号BTLA-HVEM是否参与了CD4+T细胞介导的HSK免疫病理反应。方法将106PFU的单纯疱疹病毒I型(herpes simplex virus type 1,HSV-1)KOS毒株接种于BALB/c鼠的角膜上建立HSK动物模型,分别于角膜接种病毒前(0d),接种病毒后的第3、7、10、14、21天,用毛细管取小鼠的左眼眼眶静脉窦血1mL,分离淋巴细胞,行荧光抗体染色,用流式细胞仪检测CD3+CD4+BTLA+T细胞和CD3+CD4+HVEM+T细胞阳性率;在裂隙灯显微镜下观察小鼠角膜变化;免疫组织化学方法检测BTLA蛋白及HVEM蛋白在角膜组织中的表达。结果 BALB/c鼠的角膜接种HSV-1后的1～5d,角膜擦拭液中均检测出HSV-1复制,表明小鼠感染了单纯疱疹病毒。裂隙灯显微镜观察显示:角膜接种HSV-1后第3天,所有小鼠均患了急性上皮性角膜炎,并于感染后1周内痊愈,自病毒接种后第8天起,小鼠出现角膜基质炎的改变,表现为角膜基质呈灰白色混浊,角膜基质混浊于病毒接种后的第10天达到高峰,持续至第14天后逐渐减轻。流式细胞仪检测显示,小鼠外周血淋巴细胞中CD3+CD4+BTLA+T细胞和CD3+CD4+HVEM+T细胞的阳性率,在角膜接种病毒前(0d)分别为(3.15±0.60)%和(9.84±1.06)%,在角膜接种病毒后第10天(HSK疾病程度最严重时)分别增加到(20.47±3.15)%和(45.18±3.90)%(与0d相比差异均有显著统计学意义,均为P<0.01)。免疫组织化学方法检查HSK小鼠角膜组织中BTLA和HVEM的蛋白表达结果一致:HSK临床表现最严重时,即病毒接种后第10天时,BTLA蛋白和HVEM蛋白在角膜组织中表达最强,主要表达于角膜基质层内浸润的炎性细胞上,角膜上皮层和内皮层也有表达。结论在HSK小鼠模型中,BTLA及其配体HVEM蛋白在角膜组织中及外周血CD4+T细胞上表达明显增强,共抑制信号BTLA-HVEM参与了CD4+T细胞介导的HSK的免疫病理过程。展开更多
PURPOSE:To assess the efficacy of topical cyclosporine 0.05%(Restasis)in patients with herpes simplex virus nonnecrotizing stromal keratitis unresponsive to topical prednisolone.DESIGN:Prospective case series.METHODS:...PURPOSE:To assess the efficacy of topical cyclosporine 0.05%(Restasis)in patients with herpes simplex virus nonnecrotizing stromal keratitis unresponsive to topical prednisolone.DESIGN:Prospective case series.METHODS:Patients with herpes simplex virus stromal keratitis(n=12)that was unresponsive to topical prednisolone acetate 1% for at least four weeks were evaluated at a single site.Eyes were treated with topical cyclosporine twice a day and begun on a rapid prednisolone taper.Visual acuity,slit-lamp appearance,intraocular pressure,and corneal sensitivity were evaluated every two weeks for at least three months.RESULTS:Stromal keratitis resolved with cyclosporine in 10 of 12 patients after one month.Themean lesion area decreased more with cyclosporine than with prednisolone(2.0 mm with cyclosporine compared with 0.25 mm with prednisolone).After stopping cyclosporine therapy,four patients had recurrence of stromal keratitis.CONCLUSION:This series suggests that herpes simplex virus stromal keratitis can be treated effectively with topical cyclosporine,particularly in cases that are not responsive to topical prednisolone.展开更多
文摘目的研究B、T淋巴细胞衰减因子(B and T lymphocyte attenuator,BTLA)及其配体疱疹病毒侵入介体(herpes virus entry mediator,HVEM)在单纯疱疹性角膜基质炎(herpetic stromal keratitis,HSK)小鼠角膜组织中及外周血CD4+T细胞上的表达水平,探讨共抑制信号BTLA-HVEM是否参与了CD4+T细胞介导的HSK免疫病理反应。方法将106PFU的单纯疱疹病毒I型(herpes simplex virus type 1,HSV-1)KOS毒株接种于BALB/c鼠的角膜上建立HSK动物模型,分别于角膜接种病毒前(0d),接种病毒后的第3、7、10、14、21天,用毛细管取小鼠的左眼眼眶静脉窦血1mL,分离淋巴细胞,行荧光抗体染色,用流式细胞仪检测CD3+CD4+BTLA+T细胞和CD3+CD4+HVEM+T细胞阳性率;在裂隙灯显微镜下观察小鼠角膜变化;免疫组织化学方法检测BTLA蛋白及HVEM蛋白在角膜组织中的表达。结果 BALB/c鼠的角膜接种HSV-1后的1～5d,角膜擦拭液中均检测出HSV-1复制,表明小鼠感染了单纯疱疹病毒。裂隙灯显微镜观察显示:角膜接种HSV-1后第3天,所有小鼠均患了急性上皮性角膜炎,并于感染后1周内痊愈,自病毒接种后第8天起,小鼠出现角膜基质炎的改变,表现为角膜基质呈灰白色混浊,角膜基质混浊于病毒接种后的第10天达到高峰,持续至第14天后逐渐减轻。流式细胞仪检测显示,小鼠外周血淋巴细胞中CD3+CD4+BTLA+T细胞和CD3+CD4+HVEM+T细胞的阳性率,在角膜接种病毒前(0d)分别为(3.15±0.60)%和(9.84±1.06)%,在角膜接种病毒后第10天(HSK疾病程度最严重时)分别增加到(20.47±3.15)%和(45.18±3.90)%(与0d相比差异均有显著统计学意义,均为P<0.01)。免疫组织化学方法检查HSK小鼠角膜组织中BTLA和HVEM的蛋白表达结果一致:HSK临床表现最严重时,即病毒接种后第10天时,BTLA蛋白和HVEM蛋白在角膜组织中表达最强,主要表达于角膜基质层内浸润的炎性细胞上,角膜上皮层和内皮层也有表达。结论在HSK小鼠模型中,BTLA及其配体HVEM蛋白在角膜组织中及外周血CD4+T细胞上表达明显增强,共抑制信号BTLA-HVEM参与了CD4+T细胞介导的HSK的免疫病理过程。
文摘PURPOSE:To assess the efficacy of topical cyclosporine 0.05%(Restasis)in patients with herpes simplex virus nonnecrotizing stromal keratitis unresponsive to topical prednisolone.DESIGN:Prospective case series.METHODS:Patients with herpes simplex virus stromal keratitis(n=12)that was unresponsive to topical prednisolone acetate 1% for at least four weeks were evaluated at a single site.Eyes were treated with topical cyclosporine twice a day and begun on a rapid prednisolone taper.Visual acuity,slit-lamp appearance,intraocular pressure,and corneal sensitivity were evaluated every two weeks for at least three months.RESULTS:Stromal keratitis resolved with cyclosporine in 10 of 12 patients after one month.Themean lesion area decreased more with cyclosporine than with prednisolone(2.0 mm with cyclosporine compared with 0.25 mm with prednisolone).After stopping cyclosporine therapy,four patients had recurrence of stromal keratitis.CONCLUSION:This series suggests that herpes simplex virus stromal keratitis can be treated effectively with topical cyclosporine,particularly in cases that are not responsive to topical prednisolone.
