实验性增殖性玻璃体视网膜病变的增殖细胞核抗原的表达

Expression of proliferating cell nuclear antigen in experimental traumatic proliferative vitreoretinopathy

关键词:  外伤性增殖性玻璃体视网膜病变  眼外伤；细胞增殖；视网膜色素上皮

Key words:  traumatic proliferative vitreoretinopathy  ocular trauma  proliferation  retinal pigment epithelium

摘要:

［目的］ 观察实验性外伤性增殖性玻璃体视网膜病变（traumatic proliferative vitreoretinopathy TPVR）的病理过程，以增殖细胞核抗原（proliferating cell nuclear antigen，PCNA）为细胞增殖指标，探讨TPVR的危险因素、增殖起点及各种增殖细胞的作用。［方法］ 通过眼球穿通伤并玻璃体内注入自体全血诱发大鼠TPVR模型，观察伤后1，3，5，7，14，21 d大鼠伤眼的病理衍变，用PCNA检测伤眼的增殖情况。［结果］ 眼球穿通伤后伤眼出现早期视网膜脱离或明显中性白细胞浸润，PCNA阳性细胞多且广泛；在TPVR中脱离的的视网膜色素上皮（retinal pigment epithelium RPE）细胞PCNA阳性表达在伤后1 d出现，5~7 d达到高峰，是形成视网膜下膜的主要细胞；大量PCNA阳性的成纤维细胞从伤后1 d开始经伤道长入眼内，以后逐步减少，到伤后21 d停止，它是形成视网膜前膜的主要细胞；视网膜内层PCNA阳性的细胞在伤后3 d出现，没有明显的高峰时间，是视网膜增厚，僵硬的主要原因；视网膜下膜的形成早于视网膜前膜，并广泛存在于TPVR中；在TPVR严重的眼，后期可见大量PCNA阳性并脱落的睫状上皮细胞。［结论］ 通过眼球穿通伤并玻璃体内注入自体全血可以成功地诱发大鼠TPVR模型；中性白细胞在外伤性PVR的发生发展中具有很重要的作用；在外伤性PVR中RPE细胞是形成视网膜下膜的主要细胞，成纤维细胞是视网膜前膜的主要细胞，而神经胶质细胞是视网膜增厚，僵硬的主要原因。视网膜下膜的形成早于视网膜前膜，并广泛存在于TPVR。

Abstract:

［Objective］To analyze the pathology of traumatic proliferative vitreoretinopathy (TPVR) by using proliferating cell nuclear antigen （PCNA）as a mark to observe the proliferative course during the development of experimental traumatic proliferative vitreoretinopathy (TPVR)and study the risk factors, the initial points and the roles of different cells in the formation of TPVR. ［Methods］ A rat model of traumatic proliferative vitreoretinopathy was induced by a penetrating injury at the posterior segment of an eyeball and autologous blood was injected into the midvitreous. The rats were sacrificed on 1,3,5,7,14,21 the day after injection. The slices were made and stained with and H.E and immunohistochemistry for PCNA. ［Results］ The eyes, in which the retinal detachment took place early after injury, were infiltrated by neutrophil obviously. Under the detached retina the proliferation of retinal pigment epithelium(RPE) with PCNA expression appeared on the 1st day after injury and reached a peak on the 5~7th day.RPEs were main cells to form the subretinal membrane. Massive growth of the fibroblast through the path of the wound into the ocular begun on the 1st day after injury and decreased gradually until vanished on the 21th day after injury. The fibroblast is the mainly cells which formed the preretinal membrane. The PCNA expression of the cells in the inner layer of the retina begun on the 3rd day after injury,which did not have peak time. The neuroglial cell's increasing was main reason of the retinal thickening and stiffness. The subretinal membrane formed earlier than the preretinal membrane and appeared extensively in TPVR. Many ciliary epithelia shed with PCNA expression were seen lately.［ Conclusions］ A rat model of TPVR can be induced by a penetration injury at the posterior segment of an eyeball and an injection of autologous blood into the midvitreous. The neutrophil play an important role in the forming and development of TPVR .RPE is the major cells to form the subretinal membrane. The fibroblast is the major cells to form the preretinal membrane. The increasing of neuroglial cells in the inner layer of the retina is the main reason of the retinal thickening and stiffness. The formation of subretinal membrane is earlier than that of the preretinal membrane and appeared extensively in TPVR.