增生性玻璃体视网膜病变发病机制的研究进展

增生性玻璃体视网膜病变(proliferative vitreoretinopathy，PVR)是在孔源性视网膜脱离或视网膜脱离复位术后，由于视网膜色素上皮细胞(RPE)及神经胶质细胞的增生和收缩，造成牵拉性视网膜脱离的病变。PVR的病理特征是细胞增生，RPE一旦开始增殖，就产生细胞生长因子，而这些细胞生长因子反过来又刺激细胞增殖。PVR的过程有多种细胞及因子的参与，参与PVR增生的细胞主要是RPE和视网膜神经胶质细胞；涉及PVR的生长因子有：PDGF、EGF、VEGF、TGF、FGF、IGF、HGF等。     

增生性玻璃体视网膜病变的研究进展

增生性玻璃体视网膜病变(PVR)是裂孔源性视网膜脱离手术失败最常见的原因。研究结果表明，PVR是视网膜脱离手术后的创伤愈合反应。随着视网膜的创伤，活化的视网膜色素上皮细胞，胶质细胞，纤维母细胞等增殖、迁移，与细胞外间质共同形成了PVR膜而导致牵引性视网膜脱离。就PVR的治疗而言，早期在于控制炎症，中期主要是抑制细胞增殖，晚期着重于防止纤维化的形成。着重就PVR的危险因素、临床分类、病理、手术处理以及最新的药物治疗进展做综合归纳。     

增生性玻璃体视网膜病变增殖膜的免疫组织化学研究

增生性玻璃体视网膜病变 (PVR)是孔源性视网膜脱离(rhegmatogenousretinaldetachment,RRD)手术失败的主要原因。增殖膜的形成、收缩 ,并牵拉视网膜导致视网膜脱离是主要病理过程 ,在以往的研究中我们已经发现PVR患者玻璃体切割液中存在细胞表型的变化[1] ,我们通过对 12例PVR患     

增生性玻璃体视网膜病变视网膜前膜超微结构及HGF受体表达

目的：研究增生性玻璃体视网膜病变视网膜前膜(epiretinal membrane,ERM)的超微结构及肝细胞生长因子(hepatocyte growth factor,HGF)受体的表达情况。方法：严重增生性玻璃体视网膜病变(PVR)患10例行玻璃体手术时取出视网膜前膜,透射电镜观察ERM的组成成分,免疫组化染色观察ERM组织中HGF。受体的表达。结果：ERM以上皮样细胞、成纤维样细胞为主并含有大量胶原成分。ERM标本中HGF受体集中在细胞分布密集区域表达,阳性细胞多是一些含色素颗粒的细胞。结论：视网膜色素上皮(RPE)细胞是PVR的主要参与细胞,HGF可能参与了PVR膜形成。     

与增生性玻璃体视网膜病变发病相关的细胞因子

增生性玻璃体视网膜病变( proliferative vitreoretinopathy,PVR)为视网膜表面发生无血管的纤维细胞性膜的增生,是引起视网膜脱离的主要原因.公认的PVR发病机制是一个细胞介导的病理过程,即生长因子或细胞因子假说.目前研究较多的细胞因子有血小板衍生生长因子、肝细胞生长因子和结缔组织生长因子等...     

增生性视网膜病变患者血清和玻璃体瘦素水平分析

增生性视网膜病变 ( proliferative retinopathy,PR)的病理特征是 ,纤维增生和新生血管形成 ,如伴增生性玻璃体视网膜病变 ( proliferative vitreoretinopathy,PVR)的视网膜脱离和增生性糖尿病视网膜病变 ( proliferative diabetic retinopathy,PDR)。目前 ,PR发病机制尚未完全弄清 ,可能是多种因素相互作用相互影响的结果。其中 ,增殖性细胞因子在其发病过程中可能发挥重要和关键的作用。瘦素是一种多功能细胞因子 ,业已证实 ,瘦素可调节体内能量的平衡 ,不仅如此 ,瘦素还具有促进新生血管形成和伤口愈合的作用 [1 ] 。我们通过检测血…     

转化生长因子-β在增生性玻璃体视网膜病变中的作用

增生性玻璃体视网膜病变(PVR)是孔源性视网膜脱离手术失败的主要原因,其发病机制尚未完全明了。综述了转化生长因子13．(TGF—β1)的生物学特性以及它在PVR发展中的作用。探讨TGF—β1与PVR形成的关系。TGF—β在PVR的形成过程中参与了细胞的增殖、膜的收缩。TGF—β是加速PVR形成的重要生长因子之一。将来也许可以用TGF—β的拮抗剂来预防和治疗PVR。     

早期视网膜内增生性玻璃体视网膜病变的发病机制

增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)是视网膜重建的非特异性组织修复过程中的一部分.它发生在视网膜脱离后,视网膜外层缺血,光感受器细胞逐渐死亡(主要是凋亡),神经元丢失并刺激胶质细胞(主要是Müller细胞)肥大,视网膜也开始重建及保护余下的神经元,但这一系列反应如果过度,胶质组织就会代替神经元,视网膜也会受到牵拉而缩短,发生早期的PVR改变.整个过程中,胶质细胞起始了PVR,之后视网膜色素上皮细胞发生去分化,转化为巨噬细胞或成纤维细胞样形态,之后细胞或纤维膜发生收缩,阻止了视网膜的复位,PVR随之发生.这个过程我们称之为早期视网膜内增生性玻璃体视网膜病变.     

Syndecan-1在增生性玻璃体视网膜病变增生膜中的表达

增生性玻璃体视网膜病变(proliferative vitreoretinopathv，PVR)属于眼内组织创伤愈合的一种特殊表现，可以分为炎症期、增生期和瘢痕期3个阶段，其中在增生期可以形成视网膜表面的增生膜组织，这些膜组织在瘢痕期收缩，形成对视网膜的牵拉而导致视网膜脱离。视网膜色素上皮(retinal pigment epithelium，RPE)细胞的过度增生在PVR过程中起重要作用。     

Research progress on circular RNA in fundus oculi proliferative diseases北大核心CSCD

眼底增生性疾病,如脉络膜新生血管、糖尿病视网膜病变、增生性玻璃体视网膜病变等,是以细胞增生或新生血管形成为病理特征,影响眼部正常结构及功能的一组疾病。环状RNA是一种非编码RNA,并被证实参与多种眼科疾病的病理生理过程。因此,环状RNA有希望成为治疗眼底增生性疾病的潜在靶点之一。本文就环状RNA的生理功能及其在糖尿病视网膜病变、增生性玻璃体视网膜病变、青光眼中神经胶质细胞增生等疾病和病理过程中的作用进行综述。     

增生性玻璃体视网膜病变增生膜再塑型机制的研究

目的 观察不同病程增生性玻璃体视网膜病变（PVR）增生膜中不同细胞成分、细胞外基质（ECM）、基质金属蛋白酶（MMPs）及其抑制剂（TIMPs）随病程变化的规律，探讨PVR增生膜的再塑型机制。 方法 病程2个月至8年的孔源性视网膜脱离伴PVR患者的增生膜手术标本16例，用免疫组织化学方法标记增生膜中视网膜色素上皮（RPE）细胞、胶质细胞等不同的细胞成分，纤维连接蛋白（FN）、层粘连蛋白（l aminin）、Ⅰ～Ⅳ型胶原等不同ECM成分，以及MMPs（MMP2、MMP9）和TIMP1，分析不同病程PVR增生膜中各标记成分的变化以及与病程的相关性。 结果 随PVR病程延长，增生膜中RPE细胞、MMP2、FN表达逐渐减少(P=0.014，P=0.001，P=0.008)， 胶质细胞、Ⅰ、Ⅲ型胶原逐渐增多（P=0.022，P=0.001，P=0.008)，层粘连蛋白和Ⅱ、Ⅳ型胶原均有表达，但不随病程变化。RPE细胞、MMP2、纤维连接蛋白的表达与病程呈负相关，胶质细胞、Ⅰ、Ⅲ型胶原的表达与病程呈正相关；MMP2与FN变化呈正相关。MMP9、TIMP1始终都有表达，但不随病程变化。 结论 在PVR增生膜形成和发展的过程中，增生膜中的RPE细胞、胶质细胞、FN、Ⅰ、Ⅲ型胶原、MMP2参与了PVR的再塑型过程。 (中华眼底病杂志， 2006， 22： 308-312）     

Immunohistochemical study of extracellular matrix components in epiretinal membranes of vitreoproliferative retinopathy and proliferative diabetic retinopathy

PURPOSE: The migration, proliferation, differentiation, and adhesion of cells and other cellular functions are influenced by the surrounding extracellular matrix in normal and wound healing conditions. The formation of epiretinal membranes, a wound healing process, is a serious complication of retinal diseases, the most important being proliferative diabetic retinopathy (PDR) and proliferative vitreoretinopathy (PVR). In the present study, the authors investigated the expression of various extracellular matrix components and in particular tenascin, fibronectin, laminin, collagen IV, and MMP-3 glycoprotein as well as the expression of glial fibrillary acidic protein in each type of epithelial membrane in order to elucidate the role of these molecules in the formation of these two types of membranes. METHODS: The authors performed immunohistochemistry in 14 PVR and 14 PDR membranes, using antibodies against the above mentioned extracellular matrix components. Tenascin and fibronectin were observed as major components in the extracellular matrix, while laminin and collagen type IV were detected as minor components in both types of membranes. A higher fibronectin expression in PVR compared with PDR membranes was found (p=0.0035). A positive relationship of its expression with the proliferative activity (p=0.15) and collagen type IV expression (p<0.0001) was also observed. RESULTS: Tenascin expression was positively correlated with glial fibrillary acidic protein positive cells in PDR membranes (p=0.04). Collagen type IV localized around vessels was observed with high levels in PDR membranes (p=0.0031). CONCLUSIONS: The results indicated that the extracellular matrix components seem to be involved in PVR and PDR, contributing to tissue remodeling and perhaps by different pathogenetic pathways, which could reflect different stages of development in these two types of membranes.     

An Immunohistochemical Study of IgG, Complement C_3, Collagen Type Ⅲ and Macrophage-Marker Ki-M_7 in Epiretinal Membranes

Purpose: To observe the immunological changes in epiretinal membranes from the patients with proliferative vitreoretinopathy (PVR).Methods: Twelve samples of epiretinal membranes obtained during vitreous surgeries for PVR were examined by direct and indirect immunofluorescein histochem-istry.Results: The cellular membranes in 8 cases were composed of retinal pigment epithelial cells, fibroblast-like cells, macrophages and collagen. Positive stainings of IgG. C3, collagen type 1 and macrophage-marker Ki-M7(CD68) was seen in the membranes.Conclusion : The results indicate that humoral immune components and macrophages may play an important role in the development of epiretinal membrane formation. Eye Science 1996; 12:10-14.     

增生性玻璃体视网膜病变过程中细胞外基质作用的研究进展

国内外多项有关增生性玻璃体视网膜病变(PVR)的研究结果表明,细胞外基质(ECM)的多种成分参与了PVR的形成,包括ECM结构蛋白、黏附蛋白、抗黏附蛋白、基质金属蛋白酶及其组织抑制因子等.其中,结构蛋白包括胶原、弹力纤维蛋白等,是视网膜前、后及玻璃体腔内形成增生膜的主要的非细胞成分,可以促进增生膜的收缩;黏附蛋白包括纤维连接蛋白、玻璃体连接蛋白、层黏连蛋白等,能促进增生膜中细胞与基质间的黏附,增进视网膜色素上皮的黏附、移行及分化功能等;抗黏附蛋白包括血小板反应蛋白-1、骨连接蛋白、韧连接蛋白等,可促进视网膜色素上皮的移行,促使增生膜再塑形;基质金属蛋白酶及组织抑制因子能降解多种ECM,增加增生膜中血管内皮通透性,促进新生血管的形成等.笔者就其目前国内外有关增生性玻璃体视网膜病变增生膜的研究结果予以综述,以供同道参考.(中华眼科杂志,2008,44:759-763)     

视网膜下液碱性成纤维细胞生长因子的临床意义

采用“三明治”酶链免疫分析法，检测了４３例患有视网膜脱离的视网膜下液的碱性成纤维细胞上长因子（ｂＦＧＦ）的含量，结果显示随着增殖性玻璃体视网膜病变（ＰＶＲ）严重程度的增加，样品中ｂＦＧＦ的含量也增加，高含量的ｂＦＧＦ将促进在ＰＶＲ收缩膜中占主要成分的视网膜色素上皮细胞的迁移和增殖，因此，ｂＦＧＦ有可能在ＰＶＲ在发展过程中起着重要作用。     

Pathobiology of epiretinal and subretinal membranes: possible roles for the matricellular proteins thrombospondin 1 and osteonectin (SPARC)

Epiretinal and subretinal membranes are fibrocellular proliferations which form on the surfaces of the neuroretina as a sequel to a variety of ocular diseases. When these proliferations complicate rhegmatogenous retinal detachment (a condition known as proliferative vitreoretinopathy or PVR), the membranes often contain numerous retinal pigment epithelial (RPE) cells and a variety of extracellular proteins. The extracellular proteins include adhesive proteins like collagen, laminin and fibronectin. In addition, several matricellular proteins with potential counter-adhesive functions are present in the membranes. Two such matricellular proteins, thrombospondin 1 and osteonectin (or SPARC: Secreted Protein Acidic and Rich in Cysteine), tend to be co-distributed with the RPE cells in PVR membranes. By virtue of their counter-adhesive properties, thrombospondin 1 and SPARC may reduce RPE cell-matrix adhesion and so permit key RPE cellular activities (for example, migration or shape change) in periretinal membrane development. Furthermore, within a 'cocktail' containing other proteins such as the metalloproteinases and growth factors like the scatter factor/hepatocyte growth factor family, matricellular proteins may play a role in the RPE cell dissociation from Bruch's membrane, which characterises early PVR.     

Immunochemical studies of epiretinal membranes using APAAP complexes: Evidence for macrophage involvement in traumatic proliferative vitreoretinopathy

Proliferative vitreoretinopathy is characterized by cellular proliferations in the periretinal space resulting in traction retinal detachment. Numerous cellular elements and connective tissue components have been identified by morphologic criteria as well as immunochemical techniques. In this study, we used the recently introduced APAAP (alkaline phosphatase - anti-alkaline phosphatase) immunostaining procedure to identify macrophages, T-lymphocytes, the structural proteins fibronectin, vimentin, and cytokeratin, and a proliferating cell antigen, in eleven human epiretinal membranes obtained during vitreoretinal surgery. Our results confirm that the pathologic processes in PVR are not immunologically mediated, but reveal the features of physiologic wound healing and scar formation.Posttraumatic PVR seems to be characterized by a severe initial inflammatory reaction as evidenced by the presence of numerous macrophages, whereas idiopathic PVR, as a complication of retinal detachment, may be caused by different mechanisms in the early pathogenesis.This study was supported by the Retinovit-Foundation.     

Cellular components of proliferative vitreoretinal membranes.

To understand the pathogenesis of proliferative vitreoretinal membrane formation which occurs in proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR), etc., accurate identification of the cellular components of the membrane is needed. This study was performed to identify cellular components of the membranes by means of immunohistochemical technique. 11 proliferative vitreoretinal membranes which were surgically obtained from 7 eyes with PVR and 4 eyes with PDR were stained with monoclonal antibodies against cytokeratin, glial fibrillary acidic protein (GFAP), or vimentin using immunoperoxidase technique (ABC method). In the PVR membranes, mean cell positivities for cytokeratin, GFAP and vimentin were 48%, 1% and 92%, respectively and in the PDR membranes, 0%, 5% and 93%, respectively. The above results suggest that retinal pigment epithelial cells and fibroblasts are major cellular components of PVR membranes, and that mesenchymal cells are major cellular components and glial cells are minor cellular components of PDR membranes.     

血小板源性生长因子对增生性玻璃体视网膜病变增生膜形成的影响

目的 探讨血小板源性生长因子（platelet-derived growth factor,PDGF)在增生性玻璃体视网膜病变（proliferative vitreoretinopathy,PVR)增生膜形成中的作用及PVR增生膜中是否存在PDGF的分泌细胞与靶细胞。方法 选择PVR患者的手术标本,其中视网膜前膜（epiretinal membrane,ERM)和视网膜下膜（subretinal membrane,SRM)标本各7例。采用免疫电镜方法检测PDGF及其受体在ERM、SRM中的表达及其与ERM、SRM中两种主要细胞成分即视网膜色素上皮细胞和神经胶质细胞的关系。结果 PDGF－A基7例ERM中均表达阳性,在7例SRM中5例表达阳性,标记物主要位于ERM、SRM部分细胞的胞质中。PDGF－B在7例ERM中均表达阳性,在6例SRM中5例表达阳性,标记物主要位于SRM、SRM的部分细胞胞质中,尤其集中于细胞质内一些电子密度高的椭圆形或不规则形的分泌颗粒中。提示PDGF可由ERM、SRM局部细胞产生,其在ERM、SRM的发病中起重要作用。本实验中PDGF－A和PDGF－B分别与细胞角蛋白和神经胶质纤维酸性蛋白双标记,结果显示细胞角蛋白标记阳性的细胞即视网膜色素上皮细胞和神经胶质纤维酸性蛋白标记阳性细胞－神经胶质细胞中的PDGF－A、PDGF－B蛋白表达阳性,表明视网膜色素上皮细胞和神经胶质细胞是PDGF的分泌细胞。结论 PDGF可由PVR增生膜中的细胞产生,在PVR的发病中起重要作用。视网膜色素上皮细胞和神经胶质细胞是PDGF的分泌细胞,从而为自分泌物、旁分泌机制提供依据。     

Osteopontin expression in vitreous and proliferative retinal membranes of patients with proliferative vitreous retinopathy

AIM: To analyze osteopontin (OPN) expression in vitreous and proliferative retinal membranes of patients with proliferative vitreous retinopathy (PVR). METHODS: A total of 54 vitreous fluid samples were obtained between 2009 and 2010, which contained 45 with PVR (group A) and 9 without PVR (group B). Enzyme-linked immunosorbent assay was applied to quantify the OPN concentrations in vitreous fluid. Four samples of proliferative retinal membrane were also obtained at the time of vitrectomy, and their contents of OPN were measured by Real-time RT-PCR. RESULTS: The OPN levels in the vitreous fluid were 778.48±62.06ng/mL in group A and 452.99±32.52ng/mL in group B. The vitreous OPN levels in group A were significantly higher than those in group B and to rise by time in the early stages of PVR. The average OPN levels in the proliferative retinal membranes (F=0.14) were also higher than those in the retinal pigment cells (F=0) using Real-time RT-PCR. CONCLUSION: The high vitreous and proliferative retinal membrane OPN levels in PVR suggest that OPN might promote the development of PVR. The vitreous OPN concentrations are rising by the time in the early phases of PVR.