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结膜杯状细胞,青光眼治疗中被忽视的细胞。

Conjunctival Goblet Cells, the Overlooked Cells in Glaucoma Treatment.

机构信息

Department of Drug Design and Pharmacology, University of Copenhagen.

Departments of Medical Biochemistry.

出版信息

J Glaucoma. 2019 Apr;28(4):325-333. doi: 10.1097/IJG.0000000000001168.

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide. Although no definitive cure exists, lowering of the intraocular pressure decreases the rate of progression in the majority of patients with glaucoma. Antiglaucomatous treatment modalities consist predominantly of chronic use of eye drops. It has become increasingly evident that long-term exposure to eye drops has a significant impact on the ocular surface, and thereby on patient compliance and quality of life. Maintenance of the ocular surface is highly dependent on a stable tear film. Conjunctival goblet cells (GCs) of the ocular surface play an important role in providing the innermost mucin layer of the tear film and are essential for maintaining the ocular surface homeostasis. Recent studies have reported severe side effects of antiglaucomatous drops on GCs. In particular, a preservative containing antiglaucomatous drops have been shown to affect the viability and functions of the GCs. Furthermore, GC density has been suggested as a potential predictor of surgical outcome after filtration surgery. The present review provides an overview of the current literature on the impact of antiglaucomatous eye drops on GCs as well as the impact on the ocular surface. Moreover, the existing evidence of a possible association between GC density and glaucoma filtration surgery outcome is summarized. We conclude that prostaglandin analogs spare the conjunctival GCs more compared with other antiglaucomatous drops and that GCs may be a good predictor of surgical outcome after filtration surgery. Overall, given the multiple functions of GCs in the ocular surface homeostasis, dedicated strategies should be adopted to preserve this cell population during the course of glaucoma.

摘要

青光眼是全球导致不可逆性失明的主要原因。虽然目前尚无明确的治愈方法,但降低眼压可降低大多数青光眼患者的疾病进展速度。抗青光眼治疗方法主要包括长期使用眼药水。越来越明显的是,长期接触眼药水会对眼表产生重大影响,从而影响患者的依从性和生活质量。眼表的维持高度依赖于稳定的泪膜。眼表面的结膜杯状细胞 (GC) 在提供泪膜的最内层粘蛋白层方面发挥着重要作用,对于维持眼表稳态至关重要。最近的研究报告了抗青光眼滴眼液对 GCs 的严重副作用。特别是,含有防腐剂的抗青光眼滴眼液已被证明会影响 GCs 的活力和功能。此外,GC 密度已被认为是滤过性手术术后手术结果的潜在预测因子。本综述概述了抗青光眼眼药水对 GCs 以及对眼表的影响的最新文献。此外,还总结了 GC 密度与青光眼滤过性手术结果之间可能存在关联的现有证据。我们得出的结论是,与其他抗青光眼滴眼液相比,前列腺素类似物对视神经节细胞的损伤更小,并且 GC 可能是滤过性手术术后手术结果的良好预测因子。总体而言,鉴于 GCs 在眼表稳态中的多种功能,在治疗青光眼的过程中应采取专门的策略来保护该细胞群。

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