Segawa K
Department of Ophthalmology, Shinshu University School of Medicine, Nagano-ken, Japan.
Nippon Ganka Gakkai Zasshi. 1995 Dec;99(12):1291-302.
Evidence that elastic fibers with elastin exists in the trabecular meshwork (TM) and play an important role in aqueous outflow resistance is presented. The elastic fibers consist of abundant microfibrillar components containing glycoproteins and amorphous components containing elastin. If TM tissues are digested with elastase, the cells composing trabecular sheets and Schlemm's canal are separated with a decrease of elastin and come in contact with each other with reproduction of elastin. When the anterior segments of eyes are perfused with elastase, the intraocular pressure drops with a decrease of outflow resistance. A large quantity of elastin exists in fine fibrils lying underneath the trabecular wall of Schlemm's canal in primary open angle glaucoma (POAG) eyes, in pseudoexfoliation (PE) materials of PE glaucoma eyes and in basement membrane and fine fibril-like materials of steroid glaucoma eyes. In congenital and juvenile glaucoma eyes, however, instead of elastin, fibronectin localizes in basement membrane and fine fibril-like materials. When TM tissues respond to steroid hormone, the tissues synthesize and secret microfibrils and elastin, components of the elastic fibers. Elastin gene expresses in human TM. Orally administered elastase is transferred in aqueous humor and digests elastin in TM. Therefore it is possible that such a drug decreases the outflow resistance of glaucoma eyes.
有证据表明小梁网(TM)中存在含弹性蛋白的弹性纤维,且其在房水流出阻力中起重要作用。弹性纤维由富含糖蛋白的微原纤维成分和含弹性蛋白的无定形成分组成。如果用弹性蛋白酶消化TM组织,构成小梁薄片和施莱姆管的细胞会随着弹性蛋白的减少而分离,并在弹性蛋白再生时相互接触。当用眼内弹性蛋白酶灌注眼前节时,眼内压会随着流出阻力的降低而下降。在原发性开角型青光眼(POAG)眼的施莱姆管小梁壁下方的细纤维中、剥脱性(PE)青光眼眼的剥脱性(PE)物质中以及类固醇性青光眼眼的基底膜和细纤维样物质中存在大量弹性蛋白。然而,在先天性和青少年青光眼眼中,位于基底膜和细纤维样物质中的是纤连蛋白而非弹性蛋白。当TM组织对类固醇激素产生反应时,这些组织会合成并分泌弹性纤维的成分微原纤维和弹性蛋白。弹性蛋白基因在人TM中表达。口服的弹性蛋白酶会进入房水并消化TM中的弹性蛋白。因此,这种药物有可能降低青光眼眼的流出阻力。