全身性遗传疾病对角膜移植排斥的影响

角膜移植为治疗角膜盲的主要手段,而角膜移植排斥则是决定角膜植片存活时间和病人术后视力的关键。角膜得益于其特殊的眼前节“免疫赦免”状态,使得角膜移植能够在众多器官移植中享有极低的排斥率,然而排斥反应发生的风险依然存在。当机体处于遗传物质异常的特殊状态时,宿主将通过宏观调控“免疫赦免”状态对植片的保护作用或受体对移植物排异产生的有害作用,延迟或促进角膜移植排斥反应的发生,进而影响移植物的存活时间和透明度。该文综述与角膜移植排斥相关的多种全身性遗传疾病,总结全身性遗传疾病对角膜移植排斥的影响,浅析其发生的病理生理学机制以及诊疗的特殊性。

Effects of systemic genetic diseases on corneal transplant rejection

Corneal transplantation is the main method for the treatment of corneal blindness, and corneal transplantation rejection isthe key to determining the survival time of corneal grafts and the postoperative visual acuity of patients. The cornea benefits from itsspecial anterior segment "immune amnesty" state, which enables corneal transplantation to enjoy a very low rejection rate among manyorgan transplants. However, the risk of rejection still exists. When the body is in a special state of abnormal genetic material, the hostwill delay or promote the occurrence of corneal transplant rejection by macrocontrolling the protective effect of the "immune amnesty"state on the graft or the harmful effect of the recipient on graft rejection. This in turn affects the survival time and transparency of thegraft. Therefore, this article reviews a variety of systemic genetic diseases related to corneal transplant rejection, summarizes the effectsof systemic genetic diseases on corneal transplant rejection, and briefly analyzes its pathophysiological mechanism and the particularityof diagnosis and treatment.