Cordeiro M F, Chang L, Lim K S, Daniels J T, Pleass R D, Siriwardena D, Khaw P T
Department of Pathology & Glaucoma, Moorfields Eye Hospital, London, UK.
Eye (Lond). 2000 Jun;14 ( Pt 3B):536-47. doi: 10.1038/eye.2000.141.
Advances in molecular and cell biology have led to an expansion in our knowledge and understanding of the processes involved in wound healing. We review existing and potential therapies modulating the conjunctival scarring response, with particular reference to glaucoma filtration surgery. We discuss how the refinement of present antimetabolite regimens can minimise complications and improve surgical results, and advocate their use in carefully selected patient groups. Perhaps the most promising approach is targeting biological molecules. Hence, use of fully human neutralising monoclonal antibodies to the growth factor TGF beta has potential as a useful strategy for modifying conjunctival scarring. Combination therapies may also afford an improved therapeutic index. It is hoped that future therapies can offer safer, more specific, focal and titratable treatment, with far-reaching clinical applications.
分子生物学和细胞生物学的进展使我们对伤口愈合过程的认识和理解得到了扩展。我们回顾了调节结膜瘢痕形成反应的现有及潜在疗法，尤其涉及青光眼滤过手术。我们讨论了如何优化目前的抗代谢药物方案以尽量减少并发症并改善手术效果，并主张在精心挑选的患者群体中使用这些方案。也许最有前景的方法是针对生物分子。因此，使用针对生长因子转化生长因子β（TGF-β）的全人源中和单克隆抗体有可能成为改变结膜瘢痕形成的有效策略。联合疗法也可能提供更高的治疗指数。希望未来的疗法能够提供更安全、更具特异性、局部性和可滴定性的治疗方法，并具有广泛的临床应用。
