Kase Satoru, Saito Wataru, Ohgami Kazuhiro, Yoshida Kazuhiko, Furudate Naoki, Saito Akari, Yokoi Masahiko, Kase Manabu, Ohno Shigeaki
Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo 060-8638 Japan.
Br J Ophthalmol. 2007 Oct;91(10):1376-8. doi: 10.1136/bjo.2007.119404. Epub 2007 May 23.
It is widely accepted that intravitreous levels of erythropoietin (Epo) are elevated in patients with ischaemic retinal diseases such as proliferative diabetic retinopathy (PDR). The aim of this study was to examine the expression of Epo and the Epo receptor (EpoR) in epiretinal membranes with and without diabetes.
Eighteen epiretinal membranes (PDR (n = 10), idiopathic epiretinal membranes (IERMs) without diabetes (n = 4) and inner limiting membranes (ILMs) (n = 4)) were obtained during pars plana vitrectomy. Formalin-fixed and paraffin-embedded tissues were examined by immunohistochemistry with anti-Epo and EpoR antibodies.
The histopathological findings demonstrated that PDR membranes consisted of a variety of endothelial cells forming a microvascular cavity with red blood cells and non-vascular stromal mononuclear cells. Membranous and cytoplasmic immunoreactivity for EpoR was strongly detected in endothelial cells and stromal cells in all PDR patients. Although microvessels were not observed in IERMs and ILMs, immunoreactivity for EpoR was noted in the cellular component of IERMs, and was weakly detected in ILMs. Epo was not expressed in any membrane.
EpoR was strongly expressed in microvessels of all PDR membranes. The in vivo evidence in this study suggests that Epo in the vitreous binds to EpoR in PDR membranes, which subsequently leads to the proliferation of new retinal vessels. EpoR immunoreactivity in non-vascular stromal cells in PDR membranes, and IERMs and ILMs might be indirectly correlated with ischaemia.
人们普遍认为，在增殖性糖尿病视网膜病变（PDR）等缺血性视网膜疾病患者中，玻璃体内促红细胞生成素（Epo）水平会升高。本研究的目的是检测糖尿病患者和非糖尿病患者视网膜前膜中Epo及Epo受体（EpoR）的表达情况。
在玻璃体切割手术中获取18个视网膜前膜（10个PDR视网膜前膜、4个无糖尿病的特发性视网膜前膜（IERMs）和4个内界膜（ILMs））。用抗Epo和EpoR抗体对福尔马林固定、石蜡包埋的组织进行免疫组织化学检测。
组织病理学结果显示，PDR视网膜前膜由多种内皮细胞组成，形成带有红细胞的微血管腔以及非血管性基质单核细胞。在所有PDR患者的内皮细胞和基质细胞中均强烈检测到EpoR的膜性和细胞质免疫反应性。虽然在IERMs和ILMs中未观察到微血管，但在IERMs的细胞成分中检测到EpoR免疫反应性，在ILMs中检测到的免疫反应性较弱。在任何视网膜前膜中均未检测到Epo的表达。
EpoR在所有PDR视网膜前膜的微血管中均有强烈表达。本研究中的体内证据表明，玻璃体内的Epo与PDR视网膜前膜中的EpoR结合，随后导致视网膜新生血管增殖。PDR视网膜前膜、IERMs和ILMs中非血管性基质细胞中的EpoR免疫反应性可能与缺血间接相关。
