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角膜移植中的免疫特惠现象。

Immune privilege in corneal transplantation.

机构信息

Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan; Department of Ophthalmology, Nippon Medical School, Tama-Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo, 206-8512, Japan.

Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba, 272-8513, Japan; Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

出版信息

Prog Retin Eye Res. 2019 Sep;72:100758. doi: 10.1016/j.preteyeres.2019.04.002. Epub 2019 Apr 20.

Abstract

Corneal transplantation is the most successful solid organ transplantation performed in humans. The extraordinary success of orthotopic corneal allografts, in both humans and experimental animals, is related to the phenomenon of "immune privilege". Inflammation is self-regulated to preserve ocular functions because the eye has immune privilege. At present, three major mechanisms are considered to provide immune privilege in corneal transplantation: 1) anatomical, cellular, and molecular barriers in the cornea; 2) tolerance related to anterior chamber-associated immune deviation and regulatory T cells; and 3) an immunosuppressive intraocular microenvironment. This review describes the mechanisms of immune privilege that have been elucidated from animal models of ocular inflammation, especially those involving corneal transplantation, and its relevance for the clinic. An update on molecular, cellular, and neural interactions in local and systemic immune regulation is provided. Therapeutic strategies for restoring immune privilege are also discussed.

摘要

角膜移植是人类进行的最成功的实体器官移植。同种异体角膜原位移植在人类和实验动物中取得了非凡的成功,这与“免疫特惠”现象有关。由于眼睛具有免疫特惠性,炎症受到自我调节以维持眼部功能。目前,有三种主要机制被认为可在角膜移植中提供免疫特惠性:1)角膜中的解剖学、细胞和分子屏障;2)与前房相关免疫偏离和调节性 T 细胞相关的耐受性;3)眼内抑制性微环境。本文综述了从眼部炎症的动物模型中阐明的免疫特惠机制,特别是涉及角膜移植的机制,及其与临床的相关性。还提供了局部和全身免疫调节中分子、细胞和神经相互作用的最新信息。此外,还讨论了恢复免疫特惠性的治疗策略。

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