Baddeley S M, Bacon A S, McGill J I, Lightman S L, Holgate S T, Roche W R
Department of Pathology, Southampton General Hospital, UK.
Clin Exp Allergy. 1995 Jan;25(1):41-50. doi: 10.1111/j.1365-2222.1995.tb01001.x.
Allergic eye disease has a variety of clinical manifestations including seasonal atopic conjunctivitis (SAC), perennial atopic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), and atopic blepharoconjunctivitis (ABC). We have investigated the number, distribution and protease expression of mast cells in normal and diseased conjunctiva with the use of immunohistochemistry in water-miscible resin sections. The median mast cell densities in normal subjects were 17 mm-2 in the bulbar substantia propria and 9 mm-2 in tarsal substantia propria. Mast cells were absent from the normal conjunctival epithelium at both sites. Mast cell densities were increased in the bulbar substantia propria in SAC, AKC and ABC. Tarsal substantia propria showed a significant increase in mast cells in ABC and AKC disease states. Mast cells express a range of proteases which varies according to their anatomic site. Mast cells in connective tissue are described to contain tryptase, chymase, cathepsin-G and carboxypeptidase-A, whereas mucosal mast cells contain only tryptase. In the diseased conjunctiva there was a marked reduction in proteases other than tryptase in the intraepithelial mast cells. There were also significant reductions in protease expression other than tryptase in the bulbar substantia propria in AKC and ABC. There appear to be specific alterations in the distribution of mast cells in the sub-categories of allergic eye disease. The distinction between mucosal and connective tissue mast cell phenotypes is not clear-cut and may depend on the functional state of the mast cells in relation to the microenvironment.
过敏性眼病有多种临床表现，包括季节性变应性结膜炎（SAC）、常年性变应性结膜炎（PAC）、特应性角结膜炎（AKC）和特应性睑结膜炎（ABC）。我们使用免疫组织化学方法，在水溶性树脂切片中研究了正常和患病结膜中肥大细胞的数量、分布及蛋白酶表达情况。正常受试者球结膜固有层中肥大细胞密度的中位数为17个/mm²，睑结膜固有层中为9个/mm²。在这两个部位的正常结膜上皮中均未发现肥大细胞。在SAC、AKC和ABC患者的球结膜固有层中，肥大细胞密度增加。在ABC和AKC疾病状态下，睑结膜固有层中的肥大细胞显著增多。肥大细胞表达一系列蛋白酶，其种类因解剖部位而异。结缔组织中的肥大细胞被描述为含有类胰蛋白酶、糜蛋白酶、组织蛋白酶G和羧肽酶A，而黏膜肥大细胞仅含有类胰蛋白酶。在患病结膜中，上皮内肥大细胞中除类胰蛋白酶外的其他蛋白酶显著减少。在AKC和ABC患者的球结膜固有层中，除类胰蛋白酶外的其他蛋白酶表达也显著降低。在过敏性眼病的亚类中，肥大细胞的分布似乎存在特定改变。黏膜和结缔组织肥大细胞表型之间的区别并不明确，可能取决于肥大细胞相对于微环境的功能状态。
