摘要
目的:探讨角膜免疫排斥反应的诱发因素,比较不同免疫抑制药物的治疗作用。方法:以角膜移植,免疫排斥,实验,细胞因子,药物为检索词,检索中国期刊全文数据库(1999-01/2009-06),文献检索语种限制为中文。以角膜植片存活时间评价指标。纳入角膜移植免疫排斥反应的动物实验和临床研究,排除角膜移植以外治疗角膜病的其他方法。结果:计算机初检得到570篇文献,根据纳入排除标准,对角膜免疫排斥反应的动物实验和药物治疗研究进行分析。当前用于防治角膜移植免疫排斥反应的治疗药物主要有糖皮质激素及环孢素等,然而长期应用这些药物会产生严重的并发症。白细胞介素1受体拮抗剂可以通过多种机制抑制角膜排斥反应,它可代替环孢素A发挥更大的作用,并避免环孢素A带来的不良反应,而使角膜植片的存活时间延长。雷帕霉素是一种疗效好、低毒、无肾毒性及神经毒性的新型免疫抑制剂,在不同种类的器官移植动物模型上显示出显著的抗排斥反应活性,现已将其作为器官移植抗排斥作用新药正在进行Ⅲ期临床试验。他克莫司药物缓释系统能够长时间维持房水内的他克莫司药物浓度,抑制角膜植片内白细胞介素2受体α、单核细胞趋化蛋白1、Fas及FasL mRNA的表达,可长期有效地抑制高危角膜移植后免疫排斥反应的发生。结论:了解角膜移植排斥反应的诱发因素、促进因素及发生发展机制能够在移植前和移植后有效地预防并减轻排斥反应的发生,提高角膜移植反应的成功率。
OBJECTIVE：To explore the inducing factors of immunological rejection following corneal transplantation,in addition,to compare the therapeutic effects among various immunosuppressive drugs.METHODS：Chinese Journal Full-text Database was retrieved with search terms of corneal transplantation,immunologic rejection,experiment,cytokine,and drugs from January 1999 to June 2009.The language was restricted in Chinese using survival time of corneal grafts as evaluation index.Animal experiments and clinical research regarding immunological rejection following corneal transplantation were included,and articles concerning other treatment methods for ceratonosus were excluded.RESULTS：A total of 570 papers were obtained by initial search with computer.According to inclusion criteria,papers regarding animal experiments and clinical research regarding immunological rejection following corneal transplantation were analyzed.At present,glucocorticoid and ciclosporin were mainly used in preventing and treating immunological rejection following corneal transplantation,however,the long term using of these drugs would result in severe complications.Interleukin-1 receptor antagonist can replace ciclosporin A as immunosuppressive drug,which can reduce side effect and extent the survival time of corneal grafts.Rapamycin is a new immunosuppressive agent with good effects and low toxicity,which exhibits significant effects on anti rejection.Tacrolimus drug delivery system can maintain the high drug concentration in aqueous humor for a long time,inhibit expressions of interleukin 2 receptor α,monocyte chemoattractant protein 1,Fas and FasL mRNA,which can suppress immunological rejection following high-risk corneal transplantation.CONCLUSION：Realizing inducing factors,contributory factors and mechanisms of immunological rejection following corneal transplantation take an important part in preventing immunological rejection and increasing successful rate of corneal grafts.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第44期8717-8720,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
