Bazan N G, de Abreu M T, Bazan H E
Louisiana State University, Eye Center, New Orleans.
Int Ophthalmol. 1990 Oct;14(5-6):335-44. doi: 10.1007/BF00163553.
The cellular and biochemical events triggered by uveitis involve a complex array of cells and a heterogeneous network of mediators of intraocular inflammation. Resident cells are activated and inflammatory cells are recruited. Chemical mediators from the arachidonic acid cascade, prostaglandins, hydroxyeicosatetraenoic acids, and leukotrienes, are formed. Several of these metabolites are modulators of cellular functions, but when generated in sustained, excessive amounts, they contribute to enhanced vascular permeability and to the onset of pathophysiological responses. Another very active membrane-derived mediator is platelet-activating factor. This important mediator of immune and inflammatory responses may play a central role in uveitis due to cell priming, since interleukin-1, tumor necrosis factor, and other as yet unidentified mediators are also being generated. The concomitant accumulation of these networks of mediators in various parts of the uveal tract leads to spreading of the intraocular inflammatory response and cellular damage. At both early and late stages of uveitis, the generation of free radicals is also a major contributor to the impairment of function. Free radicals are generated in two distinct sites: in the oxidative burst of recruited white cells and in free radical formation and lipid peroxidation in resident cells. The identification of the cellular events that lead to the accumulation of networks of mediators of inflammation and their effects has important therapeutic implications in uveitis.
葡萄膜炎引发的细胞和生化事件涉及一系列复杂的细胞以及眼内炎症介质的异质性网络。驻留细胞被激活，炎症细胞被募集。花生四烯酸级联反应产生化学介质，如前列腺素、羟基二十碳四烯酸和白三烯。这些代谢产物中的几种是细胞功能的调节剂，但当持续过量产生时，它们会导致血管通透性增强和病理生理反应的发生。另一种非常活跃的膜衍生介质是血小板活化因子。这种免疫和炎症反应的重要介质可能由于细胞启动在葡萄膜炎中起核心作用，因为白细胞介素-1、肿瘤坏死因子和其他尚未确定的介质也在产生。这些介质网络在葡萄膜各部位的同时积累导致眼内炎症反应的扩散和细胞损伤。在葡萄膜炎的早期和晚期，自由基的产生也是功能损害的主要原因。自由基在两个不同的部位产生：在募集的白细胞的氧化爆发中以及在驻留细胞中的自由基形成和脂质过氧化中。确定导致炎症介质网络积累的细胞事件及其影响对葡萄膜炎的治疗具有重要意义。
