Schröder S, Palinski W, Schmid-Schönbein G W
AMES-Bioengineering, University of California, San Diego, La Jolla 92093.
Am J Pathol. 1991 Jul;139(1):81-100.
Capillary occlusions are characteristic features of the early diabetic retinopathy and are presumed to initiate neovascularization. Activated leukocytes can cause microvascular occlusions and cell damage by release of cytotoxic products. To explore the role of leukocytes in capillary occlusion, nonperfusion, and neovascularization of diabetic retinopathy, a rat model was used, in which a diabetic state was induced by alloxan. Retina flat preparations were differentially stained for monocytes and granulocytes. Capillary occlusion, nonperfusion, and neovascularization were assessed microscopically in the center, midperiphery, and periphery of the retina. In contrast to control retinas, 2- to 9-month diabetic rats showed many capillary occlusions by leukocytes, especially monocytes, endothelial cell damage, extravascular macrophage accumulation, and tissue damage. The percentage of activated monocytes and granulocytes in the circulating blood of diabetic rats was greatly increased, and areas of capillary 'loss' and neovascularization in the retina coincided with sites of extravascular leukocytes. The authors' results suggest a potential role of monocytes and macrophages in the pathogenesis of diabetic retinopathy.
毛细血管闭塞是早期糖尿病视网膜病变的特征性表现，被认为是新生血管形成的起始因素。活化的白细胞可通过释放细胞毒性产物导致微血管闭塞和细胞损伤。为了探究白细胞在糖尿病视网膜病变的毛细血管闭塞、无灌注及新生血管形成中的作用，研究人员使用了一种大鼠模型，通过四氧嘧啶诱导大鼠产生糖尿病状态。对视网膜平铺片进行单核细胞和粒细胞的鉴别染色。在显微镜下评估视网膜中央、中周部和周边部的毛细血管闭塞、无灌注及新生血管形成情况。与对照视网膜相比，糖尿病2至9个月的大鼠出现了许多由白细胞尤其是单核细胞导致的毛细血管闭塞、内皮细胞损伤、血管外巨噬细胞积聚及组织损伤。糖尿病大鼠循环血液中活化单核细胞和粒细胞的百分比大幅增加，视网膜中毛细血管“缺失”和新生血管形成的区域与血管外白细胞的部位一致。作者的研究结果表明，单核细胞和巨噬细胞在糖尿病视网膜病变的发病机制中可能发挥作用。
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