Resch Miklós D, Schlötzer-Schrehardt Ursula, Hofmann-Rummelt Carmen, Kruse Friedrich E, Seitz Berthold
Department of Ophthalmology, Semmelweis University, Tömö utca 25-29, Budapest, 1083, Hungary.
Graefes Arch Clin Exp Ophthalmol. 2009 Aug;247(8):1081-8. doi: 10.1007/s00417-009-1046-1. Epub 2009 Feb 4.
The aim of the study was to investigate the histopathological and ultrastructural correlate of delayed epithelial healing in eyes with lattice corneal dystrophy (LCD).
Corneal buttons from 4 patients with LCD (two with subepithelial, two with stromal amyloid deposits) and 2 control corneas were examined. Cell-matrix adhesion molecules and basement membrane components of the corneal epithelium were analyzed by immunohistochemistry and hemidesmosomes between epithelium and stroma were quantified by transmission electron microscopy (TEM).
By TEM well-developed hemidesmosomes anchored the basal epithelial cells to the underlying basement membrane in all normal and LCD corneas. Hemidesmosome density was not significantly different in subepithelial (224.7 +/- 34.1/100 microm) and stromal (234.3 +/- 36.3/100 microm) LCD compared to controls (241.3 +/- 26.8/100 microm). The basement membrane was interrupted in subepithelial, but continuous in stromal LCD. Integrin alpha6 and beta4 staining formed a continuous line along the basal surface of the corneal epithelium in control corneas, whereas it appeared discontinuous and patchy both in subepithelial and stromal forms of LCD. Staining for alphaV integrin showed irregular staining patterns, i.e. enhanced labelling intensity in subepithelial and interrupted pattern in stromal LCD, respectively. Integrins alpha3, beta1, beta2, and beta5, dystroglycan, and plectin were not markedly different in dystrophic corneas. Type VII collagen showed a discontinuous staining in subepithelial forms of LCD. In stromal forms of LCD, type VII collagen staining occurred in additional patches underneath the epithelial basement membrane zone. Type XVII collagen staining was reduced in subepithelial LCD. Laminin-1, laminin-5 and laminin gamma2 showed variable irregular staining patterns in dystrophic corneas with focal interruptions, focal thickenings, and reduplications of basement membrane. Some irregularities in corneas with subepithelial amyloid were observed for collagen types IV, V, and XVIII, laminin alpha1, alpha3, and gamma1, nidogen-1 and -2, perlecan, fibrillin-1.
Immunohistochemical and electron microscopic evidence of structural alterations was found in LCD compared to normal corneas concerning cell-matrix adhesion molecules and basement membrane components. These alterations were more pronounced in dystrophic corneas with subepithelial amyloid deposits than in those with stromal deposits. Histopathological findings may correspond to reduced cell-matrix interactions and partly explain delayed epithelial healing in patients with lattice corneal dystrophy.
本研究的目的是调查格子状角膜营养不良(LCD)患者眼部上皮延迟愈合的组织病理学和超微结构相关性。
检查了4例LCD患者(2例为上皮下淀粉样变性,2例为基质淀粉样变性)的角膜纽扣组织以及2例对照角膜。通过免疫组织化学分析角膜上皮的细胞-基质粘附分子和基底膜成分,并通过透射电子显微镜(TEM)对上皮与基质之间的半桥粒进行定量分析。
通过TEM观察发现,在所有正常角膜和LCD角膜中,发育良好的半桥粒将基底上皮细胞锚定在下方的基底膜上。与对照组(241.3±26.8/100μm)相比,上皮下LCD(224.7±34.1/100μm)和基质LCD(234.3±36.3/100μm)中的半桥粒密度无显著差异。上皮下LCD的基底膜中断,但基质LCD的基底膜连续。在对照角膜中,整合素α6和β4染色沿角膜上皮的基底表面形成连续的线条,而在LCD的上皮下和基质形式中均表现为不连续和斑片状。αV整合素染色显示出不规则的染色模式,即上皮下LCD中标记强度增强,基质LCD中呈中断模式。在营养不良性角膜中,整合素α3、β1、β2和β5、肌营养不良蛋白聚糖和网蛋白无明显差异。VII型胶原在上皮下LCD形式中呈不连续染色。在基质LCD形式中,VII型胶原染色出现在上皮基底膜区下方的额外斑块中。XVII型胶原染色在上皮下LCD中减少。层粘连蛋白-1、层粘连蛋白-5和层粘连蛋白γ2在营养不良性角膜中显示出可变的不规则染色模式,伴有基底膜的局灶性中断、局灶性增厚和重复。在上皮下淀粉样变性的角膜中,IV型、V型和XVIII型胶原、层粘连蛋白α1、α3和γ1、巢蛋白-1和-2、基底膜聚糖、原纤维蛋白-1存在一些不规则情况。
与正常角膜相比,LCD在细胞-基质粘附分子和基底膜成分方面存在结构改变的免疫组织化学和电子显微镜证据。这些改变在上皮下有淀粉样沉积的营养不良性角膜中比在有基质沉积的角膜中更明显。组织病理学发现可能与细胞-基质相互作用减少相对应,并部分解释了格子状角膜营养不良患者上皮延迟愈合的原因。