CAJ | 학술논문

背景原发性开角型青光眼的病变部位主要位于小梁网和Schlemm管,小梁网作为眼内房水的主要排出通道,其组织特性及组织来源仍存在争议,探讨小梁网内皮的细胞属性可为原发性开角型青光眼的治疗提供新的思路.目的研究人眼小梁网中淋巴管内皮标志物D2-40和血管内皮细胞标志物CD31、CD34和平滑肌肌动蛋白(SMA)的表达,探讨小梁网的组织特性及来源.方法收集中山大学中山眼科中心病理科保存的20例前房角开放且房角结构正常的成人眼球标本,包括因外伤大失血死亡的供体眼球标本10例、眼后节黑色素瘤手术摘除眼球标本3例和眶内容物摘除的眼球标本7例.所有眼球标本沿子午线方向进行4 μm厚连续切片,行常规组织病理学检查以观察前房角、小梁网和Schlemm管的组织结构,并采用免疫组织化学染色观察D2-40、CD31、CD34和SMA在小梁网和Schlemm管组织中的表达.结果眼球组织切片中可见完整的房角结构,小梁网呈网状,Schlemm管呈无色的空腔,未见异常物质的沉积及周边组织粘连.20例眼球标本中可见小梁网内皮细胞中D2-40均呈强阳性表达,呈棕褐色染色,表达强度均为3分,而CD31、CD34和SMA表达阴性;Schlemm管内皮细胞中D2-40呈阴性表达,而CD31和CD34染色呈强阳性表达.小梁网邻近组织中血管内皮细胞可见CD31和CD34染色呈强阳性.结论小梁网组织表达淋巴管内皮标志物D2-40,但不表达血管内皮细胞标志物,提示小梁网属于淋巴管样组织.
배경 원발성개각형청광안적병변부위주요위우소량망화Schlemm관,소량망작위안내방수적주요배출통도,기조직특성급조직래원잉존재쟁의,탐토소량망내피적세포속성가위원발성개각형청광안적치료제공신적사로.목적 연구인안소량망중림파관내피표지물D2-40화혈관내피세포표지물CD31、CD34화평활기기동단백(SMA)적표체,탐토소량망적조직특성급래원.방법 수집중산대학중산안과중심병이과보존적20례전방각개방차방각결구정상적성인안구표본,포괄인외상대실혈사망적공체안구표본10례、안후절흑색소류수술적제안구표본3례화광내용물적제적안구표본7례.소유안구표본연자오선방향진행4 μm후련속절편,행상규조직병이학검사이관찰전방각、소량망화Schlemm관적조직결구,병채용면역조직화학염색관찰D2-40、CD31、CD34화SMA재소량망화Schlemm관조직중적표체.결과 안구조직절편중가견완정적방각결구,소량망정망상,Schlemm관정무색적공강,미견이상물질적침적급주변조직점련.20례안구표본중가견소량망내피세포중D2-40균정강양성표체,정종갈색염색,표체강도균위3분,이CD31、CD34화SMA표체음성;Schlemm관내피세포중D2-40정음성표체,이CD31화CD34염색정강양성표체.소량망린근조직중혈관내피세포가견CD31화CD34염색정강양성.결론 소량망조직표체림파관내피표지물D2-40,단불표체혈관내피세포표지물,제시소량망속우림파관양조직.
Background The pathological basis of human primary open angle glaucoma mainly is the degeneration of trabecular meshwork and Schlemm canal.As the outflow pathway of aqueous humor, the tissue origin and characteristics of trabecular meshwork remain less clear.Studying the characteristics of trabecular meshwork may contribute a new thought to the treatment of primary open angle glaucoma.Objective This study was to explore the histological property of trabecular meshwork by detecting the expression of D2-40, a lymphatic biomarker,and CD31,CD34 and smooth muscle actin (SMA), some vascular endothelial biomarkers.Methods Twenty specimens of adult eyeballs were collected from Zhongshan Ophthalmic Center of Sun Yat-sen University,including l0 eyeballs from accident death donors,3 enucleated eyeballs due to posterior segment of choroidal malignant melanoma and 7 orbital exenterated eyeballs.The series ocular meridian sections with the thickness of 4 μm were prepared for the haematoxylin-eosin staining.Immunohistochemistry was employed to detect the expression of D2-40,CD31 ,CD34 and SMA in trabecular meshwork and Schlemm canal.Results Intact structure of chamber angle was observed under the optical microscope by haematoxylin-eosin staining.Human trabecular meshwork tissue was presented with meshlike structure,while Schlemm canal showed the lumen structure.No abnormal substance and periphery synechia were found.D2-40 was strongly expressed in the trabecular meshwork endothelial cells with staining score for 3 points, but CD31, CD34 and SMA were negatively expressed.In contrast, CD31, CD34 and SMA rather than D2-40 were positively expressed in the Schlemm canal.In addition, CD31 and CD34 were also positively expressed in the vascular endothelial cells around the trabecular meshwork.Conclusions The trabecular meshwork expresses lymphatic biomarker rather than vascular biomarkers.This result indicates that trabecular meshwork of human eyes is lymphatic vessel-like tissue.