Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Department of Human Pathology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Sci Rep. 2017 Nov 9;7(1):15226. doi: 10.1038/s41598-017-15710-0.
The etiology of sarcoidosis is still obscure; however, Mycobacteria and Propionibacterium acnes are considered the most implicated etiological agent for sarcoidosis. To investigate whether P. acnes is an etiological agent for sarcoid uveitis, we analyzed the frequency of P. acnes detected within the biopsied retinas from patients with ocular sarcoidosis by immunohistochemistry with a P. acnes-specific monoclonal antibody (PAB antibody). Eleven patients (12 eyes) with sarcoid uveitis were enrolled in this study. Eight patients with rhegmatogenous retinal detachment, two patients with non-sarcoid uveitis, and two patients with vitreoretinal lymphoma were enrolled as controls. In the sarcoidosis group, granulomas were mainly observed in the inner retinal layer filled with CD4+ cells and CD68+ cells, indicating the Th1 immune response. P. acnes, identified as round bodies that reacted with the PAB antibody, were present in 10/12 samples (83%) from 9/11 patients (82%) with sarcoidosis. These round bodies were scattered within the retinal granulomas mainly in the inner retinal layer. In the control group, no round bodies were detected. Our results suggested that P. acnes could be associated with sarcoid uveitis. We hypothesize that sarcoid granulomas may be formed by a Th1 immune response to P. acnes hematogenously transmitted to the retina.
结节病的病因仍然不清楚；然而，分枝杆菌和痤疮丙酸杆菌被认为是最可能引起结节病的病因。为了研究痤疮丙酸杆菌是否是结节病性葡萄膜炎的病因，我们通过用痤疮丙酸杆菌特异性单克隆抗体（PAB 抗体）进行免疫组织化学分析，检测了眼部结节病患者活检视网膜中痤疮丙酸杆菌的频率。本研究纳入了 11 例（12 只眼）结节病性葡萄膜炎患者。纳入了 8 例孔源性视网膜脱离、2 例非结节病性葡萄膜炎和 2 例眼内淋巴瘤患者作为对照组。在结节病组中，主要在内层视网膜中观察到充满 CD4+细胞和 CD68+细胞的肉芽肿，表明存在 Th1 免疫反应。与 PAB 抗体反应的圆形体被鉴定为痤疮丙酸杆菌，在 9/11 例（82%）患者的 10/12 个样本（83%）中存在。这些圆形体主要在内层视网膜的视网膜肉芽肿中散在分布。在对照组中，未检测到圆形体。我们的结果表明，痤疮丙酸杆菌可能与结节病性葡萄膜炎有关。我们假设结节病肉芽肿可能是由 Th1 免疫反应形成的，这种免疫反应是由痤疮丙酸杆菌血源性传播到视网膜引起的。
