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真菌性角膜溃疡冷冻疗法的实验研究

Experimental study on cryotherapy for fungal corneal ulcer.

作者信息

Chen Yingxin, Yang Weijia, Gao Minghong, Belin Michael Wellington, Yu Hai, Yu Jing

机构信息

Department of Ophthalmology, General Hospital of Shenyang Military Area Command, No. 83 Wenhua Road, Shenhe District, Shenyang, 110840, China.

Dalian Medical University, 9 West Lvshun South Road, Dalian, 116044, China.

出版信息

BMC Ophthalmol. 2015 Mar 24;15:29. doi: 10.1186/s12886-015-0011-5.

Abstract

BACKGROUND

Fungal corneal ulcer is one of the major causes of visual impairment worldwide. Treatment of fungal corneal ulcer mainly depends on anti-fungal agents. In the current study, we developed an integrated combination therapy of cryotherapy and anti-fungal agents to facilitate effective treatment of fungal corneal ulcer.

METHODS

Rabbit models of cornea infection were established using a combined method of intrastromal injection and keratoplasty. After treatment with cryotherapy and anti-fungal agents, scanning electron microscopy, transmission electron microscopy, and confocal microscopy were conducted to observe changes in microstructure in the rabbits. Periodic acid Schiff A and hematoxylin and eosin staining were used for detection of histological changes.

RESULTS

Continuous scanning electron microscopy and transmission electron microscopy observations showed that cryothermal treatment inhibited growth of fungal mycelium by destroying fungal cellular structures. Typical cryotherapy was effective in curing fungal corneal ulcer. Different fungi showed different susceptibilities to treatment. The curative effect of Candida albicans was the best, while that of Aspergillus fumigates was the worst.

CONCLUSIONS

Our study provides a novel method of a combination of cryotherapy and anti-fungal agents for treatment of fungal corneal ulcer. This treatment could help facilitate the practice of fungal keratitis treatment in the future.

摘要

背景

真菌性角膜溃疡是全球视力损害的主要原因之一。真菌性角膜溃疡的治疗主要依赖抗真菌药物。在本研究中,我们开发了一种冷冻疗法与抗真菌药物相结合的综合治疗方法,以促进真菌性角膜溃疡的有效治疗。

方法

采用基质内注射和角膜移植相结合的方法建立兔角膜感染模型。在用冷冻疗法和抗真菌药物治疗后,进行扫描电子显微镜、透射电子显微镜和共聚焦显微镜观察,以观察兔角膜微观结构的变化。采用高碘酸希夫A染色和苏木精-伊红染色检测组织学变化。

结果

连续的扫描电子显微镜和透射电子显微镜观察表明,冷冻治疗通过破坏真菌细胞结构抑制真菌菌丝生长。典型的冷冻疗法对治愈真菌性角膜溃疡有效。不同真菌对治疗的敏感性不同。白色念珠菌的治疗效果最佳,而烟曲霉的治疗效果最差。

结论

我们的研究提供了一种冷冻疗法与抗真菌药物联合治疗真菌性角膜溃疡的新方法。这种治疗方法有助于促进未来真菌性角膜炎治疗的实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5cd/4384297/fb1ad109d1b4/12886_2015_11_Fig1_HTML.jpg

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Mycotic keratitis: epidemiology, diagnosis and management.真菌性角膜炎:流行病学、诊断与治疗。
Clin Microbiol Infect. 2013 Mar;19(3):210-20. doi: 10.1111/1469-0691.12126. Epub 2013 Feb 9.
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Spectrum of fungal keratitis in north China.中国北方真菌性角膜炎的谱系
Ophthalmology. 2006 Nov;113(11):1943-8. doi: 10.1016/j.ophtha.2006.05.035. Epub 2006 Aug 28.
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The molecular basis of cryosurgery.冷冻手术的分子基础。
BJU Int. 2005 Jun;95(9):1187-91. doi: 10.1111/j.1464-410X.2005.05502.x.

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