Taube M-A, del Mar Cendra M, Elsahn A, Christodoulides M, Hossain P
Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Eye (Lond). 2015 Nov;29(11):1399-415. doi: 10.1038/eye.2015.118. Epub 2015 Jul 10.
Microbial keratitis is a significant cause of global visual impairment and blindness. Corneal infection can be caused by a wide variety of pathogens, each of which exhibits a range of mechanisms by which the immune system is activated. The complexity of the immune response to corneal infection is only now beginning to be elucidated. Crucial to the cornea's defences are the pattern-recognition receptors: Toll-like and Nod-like receptors and the subsequent activation of inflammatory pathways. These inflammatory pathways include the inflammasome and can lead to significant tissue destruction and corneal damage, with the potential for resultant blindness. Understanding the immune mechanisms behind this tissue destruction may enable improved identification of therapeutic targets to aid development of more specific therapies for reducing corneal damage in infectious keratitis. This review summarises current knowledge of pattern-recognition receptors and their downstream pathways in response to the major keratitis-causing organisms and alludes to potential therapeutic approaches that could alleviate corneal blindness.
微生物性角膜炎是导致全球视力损害和失明的一个重要原因。角膜感染可由多种病原体引起,每种病原体都表现出一系列激活免疫系统的机制。目前才刚刚开始阐明对角膜感染的免疫反应的复杂性。模式识别受体对角膜防御至关重要:Toll样受体和Nod样受体以及随后炎症途径的激活。这些炎症途径包括炎性小体,可导致严重的组织破坏和角膜损伤,有可能导致失明。了解这种组织破坏背后的免疫机制可能有助于更好地识别治疗靶点,以促进开发更具特异性的疗法,减少感染性角膜炎中的角膜损伤。本综述总结了目前关于模式识别受体及其下游途径对主要致角膜炎病原体的反应的知识,并暗示了可能减轻角膜失明的潜在治疗方法。