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[瞳孔与黑视蛋白光感受]

[Pupil and melanopsin photoreception].

作者信息

Ishikawa Hitoshi

机构信息

Department of Orthoptics and Visual Sciences, Kitasato University School of Allied Health Sciences, Kanagawa-ken 252-0373, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 2013 Mar;117(3):246-68; discussion 269.

Abstract

The iris is the most anterior portion of the uveal tract. The pupil is round opening near the center of the iris; it is displaced slightly downward and nasally with respect to the center of the cornea. The mammalian iris sphincter is considered to be innervated by cholinergic, and the dilator muscle by adrenergic excitatory nerve fibers, and both miosis and mydriasis are the result of contraction of the iris sphincter and the dilator muscles due to activation of these excitatory nerve fibers. Pharmacological and histological investigations also reveal that the sphincter muscle is innervated in part by inhibitory adrenergic nerve fibers, and that the dilator muscle is also innervated by inhibitory cholinergic nerve fibers. In addition to the release of acetylcholine and norepinephrine by these nerves, the peripheral nerves to the mammalian iris contain various neuropeptides, although the functional role of these pepetides is not clear. It has been known for more than 100 years that two types of photosensitive cells exist in man. However, some totally blind individuals maintain a normal circadian rhythm. Such a phenomenon cannot be explained by the rod and cone functions. Recently, a new photosensitive pigment, melanopsin, was found in the dermal melanophore cells of the frog. In 2002, melanopsin-containing retinal ganglion cells (mRGCs) were discovered and revealed that mRGCs would depolarize without input from the photoreceptors, meaning that these cells are photosensitive. In the human retina, mRGCs comprise only 0.2% of all ganglion cells. Electrophysiological studies show that light slowly depolarizes mRGCs but rapidly hyperpolarizes rods and cones. The mRGCs innervate the suprachiasmatic nucleus, which is the master circadian pacemaker in mammals, and the olivary pretectal nucleus of the midbrain. In addition to their role in circadian entrainment, the mRGCs mediate the pupillary light reflex. We investigated the mechanism of photoreception by retinal photoreceptor cells, and to evaluate the relative contribution of pupil light response using the control, instigated pharmacological blockade of neurotransmission (PB) model and a transgenic model of retinal degeneration (Tg) rabbit. Although rod and cone photoreceptors disappeared in the PB and Tg models, miosis was still induced during exposure to blue light (470 nm). The greater sustained constriction of pupils to blue light in eyes with outer retinal damage reflects mRGC activation. Our study also indicated that some histologically-identified RGCs were consistent with the characteristics and structures of mRGC. Clinically, in age-related macular degeneration patients, there was no reliable recordable pupil response to red light, even at the brightest intensity but a blue light evoked a sustained pupil constriction. However, in glaucoma patients, there was no reliable recordable pupil response to the brightest intensity of blue light. These preliminary recordings in human subjects demonstrate that changes in the pupil responses to chromatic stimuli are readily detectable and easily quantifiable with standard instruments of clinical testing. We hypothesize that changes in the transient pupil response to red light and low intensity blue light may be more sensitive to cone and rod disease, whereas changes in the sustained pupil response to bright blue light may be more sensitive to optic nerve disease. Ongoing studies of the pupil are aimed at optimizing stimulus conditions that elicit pupil responses that can better localize the site of damage to rods, cones, and RGCs, to quantify the extent of disease.

摘要

虹膜是葡萄膜最前部。瞳孔是虹膜中心附近的圆形开口;相对于角膜中心,它略向下和向鼻侧移位。哺乳动物的虹膜括约肌被认为由胆碱能神经支配,而瞳孔开大肌由肾上腺素能兴奋性神经纤维支配,瞳孔缩小和散大都是由于这些兴奋性神经纤维激活导致虹膜括约肌和瞳孔开大肌收缩的结果。药理学和组织学研究还表明,括约肌部分由抑制性肾上腺素能神经纤维支配,瞳孔开大肌也由抑制性胆碱能神经纤维支配。除了这些神经释放乙酰胆碱和去甲肾上腺素外,哺乳动物虹膜的外周神经还含有各种神经肽,尽管这些肽的功能作用尚不清楚。100多年来人们一直知道人类存在两种类型的感光细胞。然而,一些完全失明的个体仍保持正常的昼夜节律。这种现象无法用视杆细胞和视锥细胞的功能来解释。最近,在青蛙的皮肤黑素细胞中发现了一种新的感光色素——黑视蛋白。2002年,发现了含黑视蛋白的视网膜神经节细胞(mRGCs),并表明mRGCs在没有光感受器输入的情况下会去极化,这意味着这些细胞是感光的。在人类视网膜中,mRGCs仅占所有神经节细胞的0.2%。电生理研究表明,光使mRGCs缓慢去极化,但使视杆细胞和视锥细胞迅速超极化。mRGCs支配视交叉上核,它是哺乳动物的主昼夜节律起搏器,以及中脑的橄榄顶盖前核。除了在昼夜节律调节中的作用外,mRGCs还介导瞳孔对光反射。我们研究了视网膜光感受器细胞的光感受机制,并使用对照、激发的神经传递药理学阻断(PB)模型和视网膜变性(Tg)兔转基因模型来评估瞳孔光反应的相对贡献。尽管在PB和Tg模型中视杆细胞和视锥细胞光感受器消失了,但在暴露于蓝光(470nm)期间仍可诱导瞳孔缩小。视网膜外层受损的眼睛中,瞳孔对蓝光的持续收缩更大,这反映了mRGCs的激活。我们的研究还表明,一些组织学鉴定的视网膜神经节细胞与mRGCs的特征和结构一致。临床上,在年龄相关性黄斑变性患者中,即使在最亮强度下,对红光也没有可靠的可记录瞳孔反应,但蓝光可引起持续的瞳孔收缩。然而,在青光眼患者中,对最亮强度的蓝光没有可靠的可记录瞳孔反应。这些在人类受试者中的初步记录表明,瞳孔对颜色刺激的反应变化很容易用临床测试的标准仪器检测到并易于量化。我们假设,对红光和低强度蓝光的瞬态瞳孔反应变化可能对视锥细胞和视杆细胞疾病更敏感,而对明亮蓝光的持续瞳孔反应变化可能对视神经疾病更敏感。正在进行的瞳孔研究旨在优化刺激条件,以引发能够更好地定位视杆细胞、视锥细胞和视网膜神经节细胞损伤部位的瞳孔反应,从而量化疾病程度。

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