Hingorani M, Calder V L, Buckley R J, Lightman S L
Institute of Ophthalmology, London, U.K.
Exp Eye Res. 1998 Nov;67(5):491-500. doi: 10.1006/exer.1998.0528.
Recent evidence suggests that mucosal epithelial cells are capable of actively participating in immune reactions via expression of surface antigens, such as adhesion molecules, and synthesis of cytokines. This appears to be important in the pathophysiology of non-ocular allergic disorders. The objectives of the experiments were to compare the expression of HLA-DR, ICAM-I and pro-allergic cytokines in conjunctival epithelial cells in the different chronic ocular allergic disorders with each other and with normal subjects. Conjunctiva from normal patients (n=10) and patients with vernal keratoconjunctivitis (VKC, n=10), atopic keratoconjunctivitis (AKC, n=10) and contact lens-associated giant papillary conjunctivitis (GPC, n=10) were examined by immunohistochemistry. Epithelial cell staining for surface antigens and cytokines was graded by one masked observer using a four point scale based on the percentage of epithelial cells staining positive. There was no expression of ICAM-1 or HLA-DR in the normal conjunctival epithelial cells, but both antigens were induced on conjunctival epithelial cells in the allergic tissue, and there was greater expression in AKC and VKC compared with GPC. Cytokines IL-6, IL-8, RANTES and TNF-alphaall localised to normal conjunctival epithelial cells. RANTES was upregulated in all the allergic disorders and IL-8 was upregulated in GPC. IL-3 and GM-CSF were not expressed in normal conjunctival epithelial cells. GM-CSF was expressed in all disorders and there was greater expression in AKC compared with GPC and VKC. IL-3 was expressed only in AKC and VKC epithelial cells. These results suggest that conjunctival epithelial cells play an important pro-inflammatory role in chronic ocular allergic diseases; ICAM-1 may allow epithelial cells to recruit, retain and locally concentrate leukocytes; the presence of HLA-DR raises the question of conjunctival epithelial cell antigen presentation. The epithelial cytokines which are upregulated are known to promote eosinophilic inflammation and are typical of allergic inflammation. The differences in cytokine patterns may be exploitable for future therapy.
最近的证据表明，黏膜上皮细胞能够通过表达表面抗原（如黏附分子）和合成细胞因子来积极参与免疫反应。这在非眼部过敏性疾病的病理生理学中似乎很重要。这些实验的目的是比较不同慢性眼部过敏性疾病的结膜上皮细胞中HLA-DR、ICAM-1和促过敏性细胞因子的表达，并与正常受试者进行比较。通过免疫组织化学检查了正常患者（n=10）、春季角结膜炎（VKC，n=10）、特应性角结膜炎（AKC，n=10）和隐形眼镜相关性巨乳头性结膜炎（GPC，n=10）患者的结膜。由一名不知情的观察者根据上皮细胞染色阳性的百分比，使用四点量表对表面抗原和细胞因子的上皮细胞染色进行分级。正常结膜上皮细胞中未表达ICAM-1或HLA-DR，但在过敏性组织的结膜上皮细胞中这两种抗原均被诱导表达，与GPC相比，AKC和VKC中的表达更高。细胞因子IL-6、IL-8、RANTES和TNF-α均定位于正常结膜上皮细胞。RANTES在所有过敏性疾病中均上调，IL-8在GPC中上调。正常结膜上皮细胞中未表达IL-3和GM-CSF。GM-CSF在所有疾病中均有表达，与GPC和VKC相比，AKC中的表达更高。IL-3仅在AKC和VKC上皮细胞中表达。这些结果表明，结膜上皮细胞在慢性眼部过敏性疾病中起重要的促炎作用；ICAM-1可能使上皮细胞募集、保留并在局部聚集白细胞；HLA-DR的存在引发了结膜上皮细胞抗原呈递的问题。上调的上皮细胞因子已知可促进嗜酸性粒细胞炎症，是过敏性炎症的典型特征。细胞因子模式的差异可能可用于未来的治疗。
