Abu el-Asrar A M, Van den Oord J J, Geboes K, Missotten L, Emarah M H, Desmet V
Department of Ophthalmology, Mansoura University Hospital, Egypt.
Graefes Arch Clin Exp Ophthalmol. 1989;227(4):374-9. doi: 10.1007/BF02169416.
The in situ immune reaction occurring in the conjunctival tissues of patients with vernal keratoconjunctivitis was studied using immunohistochemical techniques and a panel of monoclonal and polyclonal antibodies. Our data point to a complex immunopathogenesis of the disease. The anaphylactic response was demonstrated by the presence of many eosinophils and mast cells showing membranous IgE staining in the epithelial and stromal inflammatory infiltrate. IgE+ plasma cells were rare or absent in the conjunctival tissues and around the acini of accessory lacrimal glands, suggesting that IgE is not produced locally in the conjunctival tissues. A humoral immune response was evidenced by the presence of small B-lymphoid follicles, scattered B-lymphocytes, and many plasma cells in the stromal inflammatory infiltrate. IgA+ and IgG+ plasma cells were of more or less equal numbers and outnumbered IgM+ plasma cells. The majority of plasma cells around the acini of accessory lacrimal glands were IgA+. A role played by cell-mediated immunity was evident from the presence of scattered stromal T-lymphocytes and many dendritic cells in the epithelium and stroma. Some stromal dendritic cells carried IgE on their surfaces.
运用免疫组织化学技术及一组单克隆和多克隆抗体，对春季角结膜炎患者结膜组织中发生的原位免疫反应进行了研究。我们的数据表明该疾病存在复杂的免疫发病机制。在上皮和基质炎性浸润中，许多嗜酸性粒细胞和肥大细胞呈现膜性IgE染色，证实了过敏反应。在结膜组织及副泪腺腺泡周围，IgE⁺浆细胞罕见或不存在，这表明结膜组织中不会局部产生IgE。基质炎性浸润中存在小B淋巴细胞滤泡、散在的B淋巴细胞及许多浆细胞，证明了体液免疫反应。IgA⁺和IgG⁺浆细胞数量大致相等，且多于IgM⁺浆细胞。副泪腺腺泡周围的大多数浆细胞为IgA⁺。上皮和基质中散在的基质T淋巴细胞及许多树突状细胞的存在，表明细胞介导的免疫发挥了作用。一些基质树突状细胞表面携带IgE。
