Detorakis Efstathios T, Spandidos Demetrios A
Department of Ophthalmology, University Hospital of Heraklion, and Laboratory of Virology, Medical School, University of Crete, 71110 Heraklion, Crete, Greece.
Int J Mol Med. 2009 Apr;23(4):439-47. doi: 10.3892/ijmm_00000149.
Pterygium is a fibrovascular lesion of the ocular surface that can display an aggressive clinical behavior and, occasionally, threaten vision. Although there is no consensus on its pathogenesis, recent evidence suggests that it is a proliferative, rather than degenerative condition strongly correlated with exposure to ultraviolet radiation (UVR) of solar light. Molecular genetic alterations reported in association with pterygium include loss of heterozygosity (LOH), point mutations of proto-oncogenes, such as K-ras and alterations in the expression of tumor suppressor genes, such as p53 or p63. Other findings in pterygium include the frequent detection of HPV DNA, ocular surface changes such as the overexpression of various proteins, including defensins and phospolipases D, as well as the up-regulation of growth factors, such as bFGF or VEGF. Although pterygium management has traditionally involved surgery, often enhanced by the use of antimetabolites, recent advancements in the understanding of molecular and biochemical events underlying pterygium pathogenesis may enable the use of less invasive treatment methods.
翼状胬肉是一种眼表的纤维血管性病变，可表现出侵袭性的临床行为，偶尔还会威胁视力。尽管其发病机制尚无定论，但最近的证据表明，它是一种增生性疾病，而非退行性疾病，与太阳光紫外线（UVR）暴露密切相关。与翼状胬肉相关的分子遗传学改变包括杂合性缺失（LOH）、原癌基因（如K-ras）的点突变以及肿瘤抑制基因（如p53或p63）表达的改变。翼状胬肉的其他发现包括频繁检测到人乳头瘤病毒（HPV）DNA、眼表变化，如各种蛋白质（包括防御素和磷脂酶D）的过度表达，以及生长因子（如碱性成纤维细胞生长因子（bFGF）或血管内皮生长因子（VEGF））的上调。尽管传统上翼状胬肉的治疗方法是手术，通常会使用抗代谢药物来辅助，但最近对翼状胬肉发病机制背后分子和生化事件的深入了解可能会使采用侵入性较小的治疗方法成为可能。
