Karpik A G, Schwartz M M, Dickey L E, Streeten B W, Roberts J L
Clin Immunol Immunopathol. 1985 Jun;35(3):295-312. doi: 10.1016/0090-1229(85)90091-1.
Immunopathologic studies were performed on ocular tissue obtained at autopsy in five patients with systemic lupus erythematosus (SLE). The immunopathologic findings were correlated with histopathologic and clinical features of SLE. Immune reactants were demonstrated by direct immunofluorescence in all patients in a granular pattern suggesting immune complex aggregates; control ocular tissues from four patients without SLE were negative. Ultrastructural studies demonstrated corresponding electron-dense aggregates in a majority of samples. Histologic and gross anatomic evidence of inflammation were generally more focal and less frequent than the distribution of immune reactants. Most of the immune deposits were localized in the walls of blood vessels of the conjunctiva, ciliary body, retina, choroid, and sclera. Diffuse deposits were also found in association with basement membranes in ciliary body (two of five patients) and along the epithelial basement membrane in the cornea (two of five). Immune deposits in peripheral nerves of the ciliary body and conjunctiva in one patient with visual symptoms contained immunoglobulins A and E. The most intense and widespread ocular immune deposits were observed in patients with persistently increased serologic and clinical activity of their systemic disease. These results suggest a role for immune complex localization in the pathogenesis of the ocular lesions of SLE.
对5例系统性红斑狼疮（SLE）患者尸检时获取的眼部组织进行了免疫病理学研究。免疫病理学结果与SLE的组织病理学和临床特征相关。通过直接免疫荧光法在所有患者中均显示出颗粒状的免疫反应物，提示免疫复合物聚集；4例无SLE的对照患者的眼部组织为阴性。超微结构研究在大多数样本中显示出相应的电子致密聚集物。炎症的组织学和大体解剖学证据通常比免疫反应物的分布更局限且更少见。大多数免疫沉积物位于结膜、睫状体、视网膜、脉络膜和巩膜的血管壁中。在睫状体（5例患者中的2例）的基底膜和角膜上皮基底膜（5例患者中的2例）中也发现了弥漫性沉积物。1例有视觉症状的患者睫状体和结膜外周神经中的免疫沉积物含有免疫球蛋白A和E。在系统性疾病血清学和临床活动持续增加的患者中观察到最强烈和广泛的眼部免疫沉积物。这些结果表明免疫复合物定位在SLE眼部病变的发病机制中起作用。
