Lentschener C, Fredi-Reygrobellet D, Bouaziz H, Mazoit J X, Niessen F, Benhamou D
Department of Anesthesia, Université Paris-Sud, Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92141 Clamart Cedex, France.
Surg Endosc. 2000 Nov;14(11):1057-61. doi: 10.1007/s004640000257.
Increased intraperitoneal pressure in the head-down position is associated with a significant increase in intraocular pressure (IOP) in rabbits with alpha-chymotrypsin-induced glaucoma. Also, the retinal cells are weakened by the induction of increased IOP, and/or glaucoma, even when IOP is controlled by adequate therapy; therefore, these cells need to be protected from any additional aggression. Actin and vimentin are proteins of the retinal cell cytoskeleton that react readily in response to retinal injuries, including ischemia and glaucoma. Early changes in these cytoskeleton proteins determine the morphological changes observed after retinal damage. Therefore, we set out to investigate intracytoplasmic changes in vimentin and actin after a 4-h CO(2) pneumoperitoneum in the head-down position in rabbits with alpha-chymotrypsin-induced glaucoma.
Twenty-one rabbits with alpha-chymotrypsin-induced glaucoma in one eye received general anesthesia for 4 h in the head-down position and were randomly allocated to have (a) no pneumoperitoneum, (b) a 10 mmHg CO(2) pneumoperitoneum, or (c) a 20 mmHg CO(2) pneumoperitoneum. At the end of the trial, both the right glaucomatous and the left control eyes were enucleated and investigated immunocytochemically for alterations in vimentin and actin, and morphologically for retinal layer disorganization.
Except for the preexisting morphological changes induced by glaucoma, both the control and the glaucomatous eyes in all rabbits appeared normal in terms of retinal layer organization and the distribution of intracellular vimentin and actin whatever the intraperitoneal pressure level applied.
In rabbits with alpha-chymotrypsin-induced glaucoma, a 4-h CO(2) pneumoperitoneum of </=20 mmHg in the head-down position did not induce either retinal layer disorganization or alteration of actin or vimentin.
在α-糜蛋白酶诱导的青光眼兔模型中,头低位时腹腔内压力升高与眼内压(IOP)显著升高相关。此外,即使通过适当治疗控制了IOP,视网膜细胞仍会因IOP升高和/或青光眼的诱导而减弱;因此,需要保护这些细胞免受任何额外的侵害。肌动蛋白和波形蛋白是视网膜细胞骨架的蛋白质,对包括缺血和青光眼在内的视网膜损伤反应迅速。这些细胞骨架蛋白的早期变化决定了视网膜损伤后观察到的形态学变化。因此,我们着手研究α-糜蛋白酶诱导的青光眼兔头低位4小时二氧化碳气腹后波形蛋白和肌动蛋白的胞浆内变化。
21只单眼α-糜蛋白酶诱导青光眼的兔子在头低位接受全身麻醉4小时,并随机分为三组:(a)无气腹组,(b)10 mmHg二氧化碳气腹组,或(c)20 mmHg二氧化碳气腹组。试验结束时,摘除右侧青光眼眼和左侧对照眼,进行免疫细胞化学检测波形蛋白和肌动蛋白的变化,并进行形态学检测视网膜层紊乱情况。
除青光眼引起的先前形态学变化外,无论施加何种腹腔内压力水平,所有兔子的对照眼和青光眼眼中,视网膜层组织以及细胞内波形蛋白和肌动蛋白的分布均显示正常。
在α-糜蛋白酶诱导的青光眼兔中,头低位20 mmHg及以下的4小时二氧化碳气腹未诱导视网膜层紊乱或肌动蛋白及波形蛋白改变。