Lee Hyun Ju, Kim Mee Kum, Wee Won Ryang, Oh Joo Youn
*Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, Seoul, Korea; and †Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, Jongno-gu, Seoul, Korea.
Cornea. 2015 Sep;34(9):1164-7. doi: 10.1097/ICO.0000000000000471.
To report the histopathological findings of the cornea with fulminant Mooren ulcer, an idiopathic autoimmune keratitis.
A 54-year-old woman was diagnosed with Mooren ulcer. Despite intensive immunosuppression, corneal perforation developed, and penetrating keratoplasty with a limbal tectonic graft was performed. The removed cornea was histopathologically evaluated for the phenotype of the cells infiltrating the lesion.
Hematoxylin-eosin staining showed massive infiltration of inflammatory cells in the anterior corneal stroma and epithelial hyperplasia in the adjacent conjunctiva. Further analysis with immunohistochemistry indicated that the cells infiltrating the lesion included a number of CD4⁺ and CD8⁺ T lymphocytes, CD19⁺CD45⁺ B lymphocytes, and CD14⁺CD68⁺ macrophages. There were a few neutrophils and no CD56⁺ NK cells.
Our findings suggest that multiple types of immune cells including T cells, B cells, and macrophages are involved in the pathogenesis of Mooren ulcer.
报告暴发性蚕蚀性角膜溃疡（一种特发性自身免疫性角膜炎）角膜的组织病理学发现。
一名54岁女性被诊断为蚕蚀性角膜溃疡。尽管进行了强化免疫抑制治疗，但仍发生了角膜穿孔，遂行带角膜缘结构性移植的穿透性角膜移植术。对切除的角膜进行组织病理学评估，以确定浸润病变的细胞表型。
苏木精-伊红染色显示角膜前基质中有大量炎性细胞浸润，相邻结膜上皮增生。免疫组织化学进一步分析表明，浸润病变的细胞包括许多CD4⁺和CD8⁺T淋巴细胞、CD19⁺CD45⁺B淋巴细胞以及CD14⁺CD68⁺巨噬细胞。有少量中性粒细胞，无CD56⁺NK细胞。
我们的研究结果表明，包括T细胞、B细胞和巨噬细胞在内的多种免疫细胞参与了蚕蚀性角膜溃疡的发病机制。
