Morgan K M, Bruner W E, Wyszynski R E, DiMarco M S
Case Western Reserve University, VA Medical Center, Cleveland, OH.
Ophthalmology. 1988 Nov;95(11):1498-503. doi: 10.1016/s0161-6420(88)32984-2.
Evidence indicates that lysosomal enzymes can carry out corneal autolysis during corneal storage and that they are damaging to the corneal endothelium. The authors investigated the release of lysosomal enzymes into two corneal storage media (K-Sol and McCarey-Kaufman [M-K]) by paired human donor corneas during 4 degrees C storage. The authors also studied the interaction of these media with lysosomal enzymes from human cornea. K-Sol and M-K stimulated (P less than 0.01) both beta-glucuronidase and alpha-galactosidase about equally. beta-N-Acetyl-glucosaminidase, a major catabolic enzyme of the cornea, was inhibited by the chondroitin sulfate in K-Sol by over 90% (P less than 0.01). Corneas stored in M-K released more lysosomal enzymes than corneas stored in K-Sol. At 4 days, the values approached significance (P less than 0.06) and by day 10 significantly higher values were found in the M-K media (P less than 0.01). Both storage methods showed a linear release. Individual corneas were found to vary in their release rates. Whether corneas that release more enzyme will show higher endothelial cell loss or produce less successful penetrating keratoplasty grafts deserves further study.
有证据表明,溶酶体酶在角膜保存过程中可导致角膜自溶,且对角膜内皮有损害作用。作者研究了配对的人类供体角膜在4℃保存期间溶酶体酶释放到两种角膜保存介质(K-Sol和麦卡里-考夫曼[M-K])中的情况。作者还研究了这些介质与来自人类角膜的溶酶体酶之间的相互作用。K-Sol和M-K对β-葡萄糖醛酸酶和α-半乳糖苷酶的刺激作用大致相同(P<0.01)。β-N-乙酰氨基葡萄糖苷酶是角膜的一种主要分解代谢酶,K-Sol中的硫酸软骨素对其抑制作用超过90%(P<0.01)。保存在M-K中的角膜比保存在K-Sol中的角膜释放更多的溶酶体酶。在第4天时,差异接近显著水平(P<0.06),到第10天时,在M-K介质中发现的值显著更高(P<0.01)。两种保存方法均显示出线性释放。发现个体角膜的释放速率存在差异。释放更多酶的角膜是否会表现出更高的内皮细胞损失或产生成功率更低的穿透性角膜移植值得进一步研究。