Wu X Y, Tsuk A, Leibowitz H M, Trinkaus-Randall V
Boston University School of Medicine, MA 02118, USA.
Br J Ophthalmol. 1998 May;82(5):569-76. doi: 10.1136/bjo.82.5.569.
The goal was to compare the biological response of the corneal stroma with three porous materials: a melt blown microfibre web of polybutylene:polypropylene (80:20); a polyester spun laced fabric (polyethylene terephthalate), and an expanded polytetrafluoroethylene. Fifty per cent of each of the materials were modified using argon radio frequency.
Discs (6 mm in diameter) were inserted into interlamellar stromal pockets and followed for a period of 12 weeks. Clinical evaluations were performed weekly. At 6 and 12 weeks, fibroplasia and the distribution of matrix proteins and growth factors (bFGF and TGF-beta) were evaluated immunohistochemically. The characterisation of glycosaminoglycans was determined after selective extraction and digestion.
The response to the disc resembled that of a wound with a decrease in keratan sulphate and an increase in dermatan sulphate. Pretreatment of the disc reduced corneal oedema and neovascularisation. Heparan sulphate, not normally detected in the corneal stroma, was detected in the region immediately surrounding the disc and in the discs of some materials. The presence of glycosaminoglycans and collagens in the disc indicated that cells had migrated into the disc and deposited a complex matrix in all three materials. The collagen response was not surface specific. bFGF and TGF-beta were detected in the region between the disc and the stroma in the polybutylene material and became diffuse with time.
Fibroplasia occurred most rapidly into the polyester discs but was accompanied by a large number of inflammatory cells. While the distribution of collagens was not altered by the material, the expression and distribution of growth factors was material dependent. bFGF was expressed transiently and occurred before that of TGF-beta. It is predicted that the transient expression of growth factors mediates the regulation of matrix proteins.
比较角膜基质对三种多孔材料的生物学反应，这三种材料分别是：聚丁烯与聚丙烯（80:20）的熔喷微纤维网、聚酯水刺织物（聚对苯二甲酸乙二酯）以及膨体聚四氟乙烯。每种材料的50%使用氩气射频进行改性。
将直径6毫米的圆盘植入层间基质袋中，并随访12周。每周进行临床评估。在第6周和第12周，通过免疫组织化学评估纤维增生以及基质蛋白和生长因子（碱性成纤维细胞生长因子和转化生长因子-β）的分布。在选择性提取和消化后测定糖胺聚糖的特征。
对圆盘的反应类似于伤口反应，硫酸角质素减少，硫酸皮肤素增加。圆盘预处理可减轻角膜水肿和新生血管形成。在圆盘紧邻区域以及某些材料的圆盘中检测到角膜基质中通常未检测到的硫酸乙酰肝素。圆盘中糖胺聚糖和胶原蛋白的存在表明细胞已迁移到圆盘中，并在所有三种材料中沉积了复杂的基质。胶原蛋白反应并非表面特异性的。在聚丁烯材料的圆盘与基质之间的区域检测到碱性成纤维细胞生长因子和转化生长因子-β，且随时间变得弥散。
纤维增生在聚酯圆盘中发生得最快，但伴有大量炎症细胞。虽然胶原蛋白的分布不受材料影响，但生长因子的表达和分布取决于材料。碱性成纤维细胞生长因子短暂表达，且先于转化生长因子-β出现。预计生长因子的短暂表达介导了基质蛋白的调节。
