Karma A, Taskinen E, Kainulainen H, Partanen M
Department of Ophthalmology, University of Helsinki, Finland.
Br J Ophthalmol. 1992 Feb;76(2):101-6. doi: 10.1136/bjo.76.2.101.
Phenotypes of the infiltrating mononuclear cells of the lower fornix conjunctiva of nine patients with sarcoidosis and six controls were studied using monoclonal antibodies and a modified immunoperoxidase method. Four patients had sarcoidosis of recent onset (duration of 2 years or less) and five patients had a chronic disease (duration of 3 or more years). The inflammatory cells in the sarcoid conjunctival specimens were predominantly T lymphocytes, the vast majority of which were of T helper/inducer subtype expressing Leu-3a + 3b positivity. The ratio of T helper/inducer cells to T suppressor/cytotoxic cells was 3.9 on average but only 0.9 in controls. Epithelioid cell granulomas were seen in three specimens in one case of recent onset and in two chronic cases comprising a marked amount (more than 15 cells/visual field) of cells bearing phenotypes of macrophages, T cells, T helper/inducer cells and HLA-DR antigen, and in smaller quantities of T suppressor/cytotoxic cells. The mean number of all immunocompetent cell subtypes of specimens from newly diagnosed patients exceeded that of specimens from chronic patients. We believe that the sarcoid immune reaction in the conjunctiva is a dynamic process in which proliferation of immunocompetent mononuclear cells precedes the stage of granuloma formation.
采用单克隆抗体和改良免疫过氧化物酶法，对9例结节病患者和6例对照者下穹窿结膜浸润性单核细胞的表型进行了研究。4例患者为近期发病的结节病（病程2年或更短），5例患者为慢性病（病程3年或更长）。结节病结膜标本中的炎性细胞主要为T淋巴细胞，其中绝大多数为表达Leu-3a + 3b阳性的T辅助/诱导亚型。T辅助/诱导细胞与T抑制/细胞毒性细胞的平均比例为3.9，但对照组仅为0.9。在1例近期发病的患者和2例慢性病患者的3个标本中可见上皮样细胞肉芽肿，其中包含大量（超过15个细胞/视野）具有巨噬细胞、T细胞、T辅助/诱导细胞和HLA-DR抗原表型的细胞，以及少量的T抑制/细胞毒性细胞。新诊断患者标本中所有免疫活性细胞亚型的平均数量超过慢性病患者标本。我们认为结膜中的结节病免疫反应是一个动态过程，其中免疫活性单核细胞的增殖先于肉芽肿形成阶段。
