Wójcik Katarzyna A, Błasiak Janusz, Kamińska Anna, Kurowska Anna K, Szaflik Jerzy, Szaflik Jacek P
Klin Oczna. 2013;115(4):317-21.
Fuchs endothelial corneal dystrophy is a disease which occurs after the fourth decade of life. This disorder is characterized by the formation of excrescences growing from the Descemet membrane, called cormea guttata, and changes in the corneal en- dothelial cell density and morphology. The pathogenesis of Fuchs endothelial corneal dystrophy is not completely known. Auto- somal dominant mode of inheritance observed in some cases of Fuchs endothelial corneal dystrophy suggests possible genetic etiology of the disease. Environmental factors also seem to be associated with Fuchs endothelial corneal dystrophy. A growing number of reports suggest an important role of oxidative stress in this disorder. An increased level of toxic products of reactive oxygen species activity and the decreased expression of antioxidant enzymes, including thioredoxin reductase, metallothione- in 3 and superoxide dismutase 2, were detected in corneas of patients with Fuchs endothelial corneal dystrophy. The imbalance between the production and neutralization of reactive oxygen species may result in oxidative stress exerting a harmful effect on cellular components, leading to molecular and cellular damage. Mitochondria may be a key target of alterationsseen in Fuchs endothelial corneal dystrophy. An increased level of oxidative mitochondrial DNA (mtDNA) damage was detected in corneas of patients with Fuchs endothelial corneal dystrophy. Disturbance in mtDNA may cause loss of integrity of inner mitochondrial membrane potential and activate the inner apoptotic pathway. Consequently, oxidative stress may contribute to the changes in endothelial morphology and apoptosis observed in Fuchs endothelial corneal dystrophy.
富克斯角膜内皮营养不良是一种发生在40岁以后的疾病。这种病症的特征是从后弹力层长出赘生物,即角膜小滴,以及角膜内皮细胞密度和形态的改变。富克斯角膜内皮营养不良的发病机制尚不完全清楚。在一些富克斯角膜内皮营养不良病例中观察到的常染色体显性遗传模式提示了该疾病可能的遗传病因。环境因素似乎也与富克斯角膜内皮营养不良有关。越来越多的报告表明氧化应激在这种病症中起重要作用。在富克斯角膜内皮营养不良患者的角膜中检测到活性氧物质活性的有毒产物水平升高以及抗氧化酶(包括硫氧还蛋白还原酶、金属硫蛋白3和超氧化物歧化酶2)的表达降低。活性氧物质产生与中和之间的失衡可能导致氧化应激对细胞成分产生有害影响,从而导致分子和细胞损伤。线粒体可能是富克斯角膜内皮营养不良中所见改变的关键靶点。在富克斯角膜内皮营养不良患者的角膜中检测到氧化线粒体DNA(mtDNA)损伤水平升高。mtDNA的紊乱可能导致线粒体内膜电位完整性丧失并激活内在凋亡途径。因此,氧化应激可能导致富克斯角膜内皮营养不良中观察到的内皮形态改变和细胞凋亡。