Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Molecular Biotechnology Programme, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Eye (Lond). 2020 Jun;34(6):1047-1050. doi: 10.1038/s41433-020-0786-3. Epub 2020 Feb 6.
Pterygia are common conjunctival degenerations with well-documented risk factors but an unclear pathogenesis. Better understanding of the pathogenesis of pterygium could lead to improved surgical outcomes and decreased postoperative recurrence. Currently, pterygium excision with conjunctival autograft remains the preferred surgical technique to decrease pterygium recurrence. Many adjuvant therapies have been used in pterygium surgery to varying degrees of success. Topical cyclosporine, an immunosuppressive medication, in conjunction with conjunctival autograft was found to be most successful in decreasing pterygium recurrence according to a recent meta-analysis. Other adjuvant therapies such as mitomycin-C (MMC), 5-fluorouracil (5-FU), and beta-irradiation have also been used, though usage of these may cause multiple adverse effects. Recent research indicates that interactions between mouse double minute 2 (MDM2) and p53 could play a role in the occurrence of pterygium. Nutlin, an MDM2 antagonist, was found to have significantly less toxicity in conjunctival cells when compared with MMC on laboratory analysis of pterygium samples.
翼状胬肉是一种常见的结膜变性疾病，其发病风险因素已得到充分证实，但发病机制尚不清楚。更好地了解翼状胬肉的发病机制可能会提高手术效果并降低术后复发率。目前，翼状胬肉切除术联合结膜自体移植仍然是降低翼状胬肉复发的首选手术方法。许多辅助治疗方法已在翼状胬肉手术中得到不同程度的应用。根据最近的一项荟萃分析，局部免疫抑制剂环孢素 A 联合结膜自体移植在降低翼状胬肉复发方面最为有效。其他辅助治疗方法，如丝裂霉素 C (MMC)、5-氟尿嘧啶 (5-FU) 和β射线照射也已被应用，但这些方法的使用可能会引起多种不良反应。最近的研究表明，鼠双微体 2 (MDM2) 和 p53 之间的相互作用可能在翼状胬肉的发生中起作用。在对翼状胬肉样本的实验室分析中，与 MMC 相比，MDM2 拮抗剂 Nutlin 在结膜细胞中表现出明显较低的毒性。
