利用流式细胞术对特应性角结膜炎免疫病理学的进一步研究。

Avunduk A M, Avunduk M C, Dayanir V, Tekelioglu Y

Karadeniz Technical University, School of Medicine, Department of Ophthalmology, Trabzon, Turkey.

Exp Eye Res. 1997 Dec;65(6):803-8. doi: 10.1006/exer.1997.0398.

Atopic keratoconjunctivitis (AKC) is an ocular manifestation of systemic hypersensitivity. Although the pathogenesis of AKC is not fully understood, some previous data suggest that a decrease in numbers of suppressor T lymphocyte (Ts) and increase of Th, especially Th2 (the second subgroup of helper T lymphocyte), at the ocular surface may play an important role in the occurrence of the disease. In this study, the percentages of naive-Th (CD4/45RA+) and memory-Th (CD4/29+) cells, and the Th/Ts and memory-Th cells/naive-Th cells ratios were measured in the blood and tear samples of patients with AKC, atopic patients without ocular involvement and normal volunteers, using flow cytometry. Groups were compared using the Mann-Whitney U test. We found that patients with AKC had significantly higher memory-Th cell concentration, and Th/Ts and memory-Th cells/naive-Th cell ratios both in the tear and blood samples compared to normal subjects. While no significant difference existed between the tear samples of the atopic patients without ocular involvement and normal volunteers with respect to the above values, atopic patients had higher percentages of memory-Th cells and higher Th/Ts and memory-Th cells/naive-Th ratios in their blood than normal subjects. The percentages of memory-Th cells, and the Th/Ts and memory-Th cells/naive-Th cell ratios in the tear samples of AKC patients were also found to be higher than that of the atopic patients without ocular involvement, but no significant difference was present between the blood samples of these groups. The percentages of naive-Th cells did not show any significant difference between groups either in tear or blood samples. Since the mean memory-Th cells/naive-Th1 cells ratio in the tear samples of the patients with AKC was higher than in their blood samples, we propose that the localized accumulation of memory-Th2 cells, in addition to the increase of Th/Ts ratios in the external eye may cause AKC in atopic individuals.

特应性角结膜炎（AKC）是一种全身性超敏反应的眼部表现。尽管AKC的发病机制尚未完全明确，但先前的一些数据表明，眼表抑制性T淋巴细胞（Ts）数量减少以及辅助性T淋巴细胞（Th）增加，尤其是Th2（辅助性T淋巴细胞的第二个亚群），可能在该病的发生中起重要作用。在本研究中，使用流式细胞术检测了AKC患者、无眼部受累的特应性患者以及正常志愿者的血液和泪液样本中初始Th细胞（CD4/45RA+）和记忆性Th细胞（CD4/29+）的百分比，以及Th/Ts和记忆性Th细胞/初始Th细胞的比例。使用Mann-Whitney U检验对各组进行比较。我们发现，与正常受试者相比，AKC患者的泪液和血液样本中记忆性Th细胞浓度、Th/Ts以及记忆性Th细胞/初始Th细胞的比例均显著更高。在上述数值方面，无眼部受累的特应性患者的泪液样本与正常志愿者之间无显著差异，但特应性患者血液中的记忆性Th细胞百分比、Th/Ts以及记忆性Th细胞/初始Th细胞比例高于正常受试者。还发现AKC患者泪液样本中的记忆性Th细胞百分比、Th/Ts以及记忆性Th细胞/初始Th细胞比例高于无眼部受累的特应性患者，但这些组的血液样本之间无显著差异。各组的初始Th细胞百分比在泪液或血液样本中均未显示出任何显著差异。由于AKC患者泪液样本中的平均记忆性Th细胞/初始Th1细胞比例高于其血液样本，我们提出，除了眼外Th/Ts比例增加外，记忆性Th2细胞的局部积聚可能导致特应性个体发生AKC。