Weller M, Heimann K, Wiedemann P
Abt. für Netzhaut- und Glaskörperchirurgie, Universitäts-Augenklinik Köln.
Klin Monbl Augenheilkd. 1990 Mar;196(3):121-7. doi: 10.1055/s-2008-1046141.
Recent studies on the natural course of proliferative vitreoretinopathy (PVR) have focused on the mononuclear phagocyte system (MPS). Although the precise origin of these cells is not known, current evidence indicates that peripheral blood monocytes infiltrate a lesion initially, subsequently giving way to resident phagocytic cells. In this context the authors try to clarify some aspects of the confusing nomenclature of phagocytic monocytes, macrophages, and microglia. The concept of the blood-retinal barrier (BRB) and its breakdown in PVR are presented and discussed. Platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta), both secretory products of macrophages, have recently been implicated in the development of vitreoretinal pathology. These studies, however, are difficult to evaluate because the biological effects of different growth factors are closely interrelated and vary widely, including both inhibition as well as stimulation of cell growth. The authors hypothesize that plasma of macrophage-derived TGF-beta provokes an increase in fibronectin synthesis, which in turn is responsible for the fibrotic rebuilding of the vitreoretinal interface in PVR. As an adjunct to the pharmacological treatment of PVR with Daunomycin the use of steroids is recommended to suppress the initial macrophage activation and related dysfunction of the BRB.
近期关于增殖性玻璃体视网膜病变（PVR）自然病程的研究聚焦于单核吞噬细胞系统（MPS）。尽管这些细胞的确切起源尚不清楚，但目前的证据表明，外周血单核细胞最初浸润病变部位，随后被局部吞噬细胞取代。在此背景下，作者试图厘清吞噬性单核细胞、巨噬细胞和小胶质细胞这一令人困惑的命名法的某些方面。文中介绍并讨论了血视网膜屏障（BRB）的概念及其在PVR中的破坏情况。巨噬细胞的分泌产物血小板衍生生长因子（PDGF）和转化生长因子-β（TGF-β）最近被认为与玻璃体视网膜病变的发展有关。然而，这些研究难以评估，因为不同生长因子的生物学效应密切相关且差异很大，包括对细胞生长的抑制和刺激作用。作者推测，巨噬细胞衍生的TGF-β血浆会促使纤连蛋白合成增加，进而导致PVR中玻璃体视网膜界面的纤维化重建。作为用柔红霉素对PVR进行药物治疗的辅助手段，建议使用类固醇来抑制最初的巨噬细胞激活及相关的BRB功能障碍。
