Limb G A, Chignell A H, Woon H, Green W, Cole C J, Dumonde D C
Immunology Research Unit, Rayne Institute, St Thomas' Hospital, London, UK.
Graefes Arch Clin Exp Ophthalmol. 1996 Apr;234(4):213-20. doi: 10.1007/BF00430412.
Epiretinal membranes from eyes with proliferative vitreoretinopathy (PVR) frequently express molecules associated with chronic inflammation. To investigate the extent to which inflammation may compromise the detached retina, we determined the expression of inflammatory molecules in anterior retina removed after relaxing retinotomy for retinal detachment complicated by anterior PVR.
Surgical retinal specimens were studied immunohistochemically for the distribution of the vascular cell adhesion molecules VCAM, E-selectin, P-selectin, ICAM and PECAM and for the presence of the cytokine TNF alpha and of T lymphocytes (CD3-positive cells), macrophages (CD68-positive cells) and HLA-DR molecules. The findings were compared with those in control cadaveric retina.
Aberrant expression of ICAM-1 was observed in four of nine retinal specimens from eyes with PVR, whereas its expression in control retinas was confined to the external limiting membrane and ganglion cell layers. PECAM was observed in seven of nine surgical retinal specimens and in four of five controls. E-selectin and P-selectin were expressed within the luminal aspects of four of nine retinal specimens from eyes with PVR, and VCAM was present in three of nine surgical specimens investigated. All cadaveric control retinas were negative for E-selectin and VCAM, whilst one was positive for P-selectin. Staining for TNF alpha was observed within luminal aspects and walls of retinal vessels from eight of nine surgical specimens, but was not seen in any of the cadaveric controls. T lymphocytes and cells expressing the macrophage marker CD68 were identified in two and seven of nine diseased retinas respectively, but not in any of the controls. Cells staining for HLA-DR were observed in eight of nine surgical retinal specimens and in three of five controls.
The present findings indicate that retina from eyes with advanced PVR may itself be subject to inflammatory changes, and indicate that the PVR process is not limited to retinal membranes, but involves a more widespread distribution of inflammation than is generally appreciated.
增殖性玻璃体视网膜病变（PVR）患者眼中的视网膜前膜常表达与慢性炎症相关的分子。为了研究炎症对脱离视网膜的损害程度，我们测定了因前部PVR并发视网膜脱离而行视网膜切开松解术后切除的前部视网膜中炎症分子的表达。
采用免疫组织化学方法研究手术切除的视网膜标本中血管细胞黏附分子VCAM、E-选择素、P-选择素、ICAM和PECAM的分布，以及细胞因子TNFα、T淋巴细胞（CD3阳性细胞）、巨噬细胞（CD68阳性细胞）和HLA-DR分子的存在情况。将研究结果与对照尸体视网膜的结果进行比较。
在9例PVR患者的视网膜标本中，有4例观察到ICAM-1异常表达，而在对照视网膜中，其表达仅限于外界膜和神经节细胞层。9例手术切除的视网膜标本中有7例观察到PECAM，5例对照中有4例观察到。9例PVR患者的视网膜标本中有4例在管腔内表达E-选择素和P-选择素，9例手术标本中有3例检测到VCAM。所有尸体对照视网膜的E-选择素和VCAM均为阴性，1例P-选择素为阳性。9例手术标本中有8例在视网膜血管管腔和管壁内观察到TNFα染色，但在任何尸体对照中均未观察到。9例患病视网膜中分别有2例和7例鉴定出T淋巴细胞和表达巨噬细胞标志物CD68的细胞，但在任何对照中均未发现。9例手术切除的视网膜标本中有8例观察到HLA-DR染色细胞，5例对照中有3例观察到。
目前的研究结果表明，晚期PVR患者的视网膜本身可能会发生炎症变化，提示PVR过程不仅限于视网膜前膜，而且炎症分布比一般认为的更为广泛。
