University of Pittsburgh, Department of Ophthalmology, Pittsburgh, PA 15213, United States.
Prog Retin Eye Res. 2013 Jan;32:88-101. doi: 10.1016/j.preteyeres.2012.08.002. Epub 2012 Aug 27.
Herpes simplex virus-1 (HSV-1) infects the majority of the world's population. These infections are often asymptomatic, but ocular HSV-1 infections cause multiple pathologies with perhaps the most destructive being herpes stromal keratitis (HSK). HSK lesions, which are immunoinflammatory in nature, can recur throughout life and often cause progressive corneal scaring resulting in visual impairment. Current treatment involves broad local immunosuppression with topical steroids along with antiviral coverage. Unfortunately, the immunopathologic mechanisms defined in animal models of HSK have not yet translated into improved therapy. Herein, we review the clinical epidemiology and pathology of the disease and summarize the large amount of basic research regarding the immunopathology of HSK. We examine the role of the innate and adaptive immune system in the clearance of virus and the destruction of the normal corneal architecture that is typical of HSK. Our goal is to define current knowledge of the pathogenic mechanisms and recurrent nature of HSK and identify areas that require further study.
单纯疱疹病毒 1 型（HSV-1）感染了世界上大多数人口。这些感染通常是无症状的，但眼部 HSV-1 感染会导致多种病理变化，其中最具破坏性的可能是疱疹性基质角膜炎（HSK）。HSK 病变具有免疫炎症性质，可在一生中反复发作，并经常导致进行性角膜瘢痕形成，从而导致视力损害。目前的治疗方法包括局部皮质类固醇的广泛局部免疫抑制以及抗病毒治疗。不幸的是，HSK 动物模型中定义的免疫病理机制尚未转化为改善的治疗方法。本文综述了该疾病的临床流行病学和病理学，并总结了大量关于 HSK 免疫病理学的基础研究。我们研究了先天和适应性免疫系统在清除病毒和破坏 HSK 典型的正常角膜结构方面的作用。我们的目标是确定 HSK 的发病机制和复发性质的现有知识，并确定需要进一步研究的领域。
