山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (2): 151-158.doi: 10.6040/j.issn.1673-3770.0.2021.536

• 综述 • 上一篇    

炎症因子在圆锥角膜中的研究进展

李孟婷,何书喜,王华   

  1. 湖南师范大学附属第一医院/湖南省人民医院 眼视光中心, 湖南 长沙 410005;
  • 发布日期:2023-03-30
  • 基金资助:
    湖南创新型省份建设项目专项任务书(2020SK218);湖南省人民医院院内项目(RS201614)

Research progress of inflammatory factors in Keratoconus

LI Mengting, HE Shuxi, WANG Hua   

  1. The Optometry Center, The First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital, Changsha 410005, Hunan, China
  • Published:2023-03-30

摘要: 圆锥角膜(KC)是一种进行性的角膜扩张性疾病,常常导致近视加重、散光增加。圆锥角膜的病理生理机制尚不完全清楚,除遗传因素外,近年来有很多关于KC和炎症性因素的研究。有研究表明在KC患者的泪液中发现有可检测水平的炎症因子与蛋白酶,其中发现KC患者泪液的白细胞介素-6、肿瘤坏死因子-α和基质金属蛋白酶-9水平升高,且升高的水平与KC的病程发展呈正相关。除此之外,一些外界因素可以通过某些行为间接导致炎症的加重,从而加速KC的发生发展,比如揉眼、过敏反应等。病理性揉眼会使角膜形态发生变化,同时改变角膜环境,导致角膜间接性损伤。过敏反应中的免疫球蛋白E则是KC的潜在炎症分子。论文从炎症因子的来源、导致KC的途径进行综述。

关键词: 圆锥角膜, 炎症因子, 氧化应激, 过敏, 病理机制

Abstract: Keratoconus(KC)is a progressive corneal dilation disease, which aggravates myopia and astigmatism. The pathophysiological mechanism of KC remains vague. The role of genetic and inflammatory factors on KC has been investigated by previous studies. Detectable levels of inflammatory factors and proteases were found in the tears of patients with KC. Interleukin-6, tumor necrosis factor-α, and matrix metalloproteinase-9 were found in the tears of patients with KC. A higher level was positively correlated with the clinical course of KC. In addition, some external factors can indirectly lead to the aggravation of inflammation through certain behaviors, thus accelerating the occurrence and development of KC, such as eye rubbing, allergic reaction, etc. Pathological eye rubbing will change the corneal morphology, change the corneal environment, and cause indirect corneal injury. Immunoglobulin E in allergic reaction is the potential inflammatory molecule of KC. This paper aimed to review previous studies on inflammatory factors and the pathways leading to KC.

Key words: Keratoconus, Inflammatory factor, Oxidative stress, Allergic, Pathological mechanism

中图分类号: 

  • R772.2
[1] Shetty R, D'Souza S, Khamar P, et al. Biochemical markers and alterations in keratoconus[J]. Asia Pac J Ophthalmol(hpila), 2020, 9(6): 533-540. doi:10.1097/apo.0000000000000332
[2] Saghizadeh M, Chwa M, Aoki A, et al. Altered expression of growth factors and cytokines in keratoconus, bullous keratopathy and diabetic human corneas[J]. Exp Eye Res, 2001, 73(2): 179-189. doi:10.1006/exer.2001.1028
[3] Lema I, Durán JA, Ruiz C, et al. Inflammatory response to contact lenses in patients with keratoconus compared with myopic subjects[J]. Cornea, 2008, 27(7): 758-763. doi:10.1097/ICO.0b013e31816a3591
[4] Balasubramanian SA, Mohan S, Pye DC, et al. Proteases, proteolysis and inflammatory molecules in the tears of people with keratoconus[J]. Acta Ophthalmol, 2012, 90(4): e303-e309. doi:10.1111/j.1755-3768.2011.02369.x
[5] Kolozsvári BL, Berta A, Petrovski G, et al. Alterations of tear mediators in patients with keratoconus after corneal crosslinking associate with corneal changes[J]. PLoS One, 2013, 8(10): e76333. doi:10.1371/journal.pone.0076333
[6] Yabuta C, Yano F, Fujii A, et al. Galectin-3 enhances epithelial cell adhesion and wound healing in rat cornea[J]. Ophthalmic Res, 2014, 51(2): 96-103. doi:10.1159/000355846
[7] McMonnies CW. Inflammation and keratoconus[J]. Optom Vis Sci, 2015, 92(2): e35-e41. doi:10.1097/opx.0000000000000455
[8] Wilson SE, He YG, Weng J, et al. Epithelial injury induces keratocyte apoptosis: hypothesized role for the interleukin-1 system in the modulation of corneal tissue organization and wound healing[J]. Exp Eye Res, 1996, 62(4): 325-327. doi:10.1006/exer.1996.0038
[9] Balasubramanian SA, Pye DC, Willcox MD. Are proteinases the reason for keratoconus? [J]. Curr Eye Res, 2010, 35(3): 185-191. doi:10.3109/02713680903477824
[10] Abu-Amero KK, Azad TA, Kalantan H, et al. Mitochondrial sequence changes in keratoconus patients[J]. Invest Ophthalmol Vis Sci, 2014, 55(3): 1706-1710. doi:10.1167/iovs.14-13938
[11] Nabil KM, Elhady GM, Morsy H. The association between interleukin 1 beta promoter polymorphisms and keratoconus incidence and severity in an Egyptian population[J]. Clin Ophthalmol, 2019, 13: 2217-2223. doi:10.2147/OPTH.S220723
[12] Balasubramanian SA, Pye DC, Willcox MDP. Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears: relevance in keratoconus[J]. Clin Exp Optom, 2013, 96(2): 214-218. doi:10.1111/cxo.12038
[13] Ebihara N, Matsuda A, Nakamura S, et al. Role of the IL-6 classic- and trans-signaling pathways in corneal sterile inflammation and wound healing[J]. Invest Ophthalmol Vis Sci, 2011, 52(12): 8549-8557. doi:10.1167/iovs.11-7956
[14] Jones SA, Horiuchi S, Topley N, et al. The soluble interleukin 6 receptor: mechanisms of production and implications in disease[J]. FASEB J, 2001, 15(1): 43-58. doi:10.1096/fj.99-1003rev
[15] Huovila APJ, Turner AJ, Pelto-Huikko M, et al. Shedding light on ADAM metalloproteinases[J]. Trends Biochem Sci, 2005, 30(7): 413-422. doi:10.1016/j.tibs.2005.05.006
[16] Izumi-Nagai K, Nagai N, Ozawa Y, et al. Interleukin-6 receptor-mediated activation of signal transducer and activator of transcription-3(STAT3)promotes choroidal neovascularization[J]. Am J Pathol, 2007, 170(6): 2149-2158. doi:10.2353/ajpath.2007.061018
[17] Abraham LJ, Kroeger KM. Impact of the-308 TNF promoter polymorphism on the transcriptional regulation of the TNF gene: relevance to disease[J]. J Leukoc Biol, 1999, 66(4): 562-566. doi:10.1002/jlb.66.4.562
[18] Arbab M, Tahir S, Niazi MK, et al. TNF-α genetic predisposition and higher expression of inflammatory pathway components in keratoconus[J]. Invest Ophthalmol Vis Sci, 2017, 58(9): 3481-3487. doi:10.1167/iovs.16-21400
[19] Beyaert R, Fiers W. Molecular mechanisms of tumor necrosis factor-induced cytotoxicity. What we do understand and what we do not[J]. FEBS Lett, 1994, 340(1/2): 9-16. doi:10.1016/0014-5793(94)80163-0
[20] Shetty R, Ghosh A, Lim RR, et al. Elevated expression of matrix metalloproteinase-9 and inflammatory cytokines in keratoconus patients is inhibited by cyclosporine A[J]. Invest Ophthalmol Vis Sci, 2015, 56(2): 738-750. doi:10.1167/iovs.14-14831
[21] Amento EP, Beck LS. TGF-beta and wound healing[J]. Ciba Found Symp, 1991, 157:115-123. doi:10.1002/9780470514061.ch8
[22] Saika S. TGF-β pathobiology in the eye[J]. Laboratory investigation, 2006, 86(2):106-115. doi: 10.1038/labinvest.3700375
[23] Sanford LP, Ormsby I, Gittenberger-de Groot AC, et al. TGFbeta2 knockout mice have multiple developmental defects that are non-overlapping with other TGFbeta knockout phenotypes[J]. Development, 1997, 124(13): 2659-2670. doi:10.1242/dev.124.13.2659
[24] Priyadarsini S, McKay TB, Sarker-Nag A, et al. Keratoconus in vitro and the key players of the TGF-β pathway[J]. Mol Vis, 2015, 21: 577-588
[25] Engler C, Chakravarti S, Doyle J, et al. Transforming growth factor-β signaling pathway activation in Keratoconus[J]. Am J Ophthalmol, 2011, 151(5): 752-759.e2. doi:10.1016/j.ajo.2010.11.008
[26] Al Qattan A, Lessard L, Philip A, et al. Abstract 84: nAG(a salamander-derived protein)as an inhibitor of TGF-β signaling and fibrotic responses. PSRC 2018 Abstract supplement, 2018: 67-68. doi: 10.1097/01.GOX.0000533949.54354.9b
[27] Lyon D', McKay TB, Sarkar-Nag A, et al. Human keratoconus cell contractility is mediated by transforming growth factor-beta isoforms[J]. J Funct Biomater, 2015, 6(2): 422-438. doi:10.3390/jfb6020422
[28] Yang YN, Wang F, Zhou W, et al. TNF-α stimulates MMP-2 and MMP-9 activities in human corneal epithelial cells via the activation of FAK/ERK signaling[J]. Ophthalmic Res, 2012, 48(4): 165-170. doi:10.1159/000338819
[29] Aren A, Gökçe AH, Gökçe FS, et al. Roles of matrix metalloproteinases in the etiology of inguinal hernia[J]. Hernia, 2011, 15(6): 667-671. doi:10.1007/s10029-011-0846-5
[30] Nagase H, Woessner JF Jr. Matrix metalloproteinases[J]. J Biol Chem, 1999, 274(31): 21491-21494. doi:10.1074/jbc.274.31.21491
[31] Fini ME, Cook JR, Mohan R. Proteolytic mechanisms in corneal ulceration and repair[J]. Arch Dermatol Res, 1998, 290: S12-S23. doi:10.1007/pl00007449
[32] Du G, Liu C, Li X, et al. Induction of matrix metalloproteinase-1 by tumor necrosis factor-α is mediated by interleukin-6 in cultured fibroblasts of keratoconus[J]. Exp Biol(Med Maywood), 2016, 241(18): 2033-2041. doi:10.1177/1535370216650940
[33] Librach CL, Feigenbaum SL, Bass KE, et al. Interleukin-1 beta regulates human cytotrophoblast metalloproteinase activity and invasion in vitro[J]. J Biol Chem, 1994, 269(25): 17125-17131. doi:10.1016/S0021-9258(17)32529-2
[34] Vettraino IM, Roby J, Tolley T, et al. Collagenase-I, stromelysin-I, and matrilysin are expressed within the placenta during multiple stages of human pregnancy[J]. Placenta, 1996, 17(8): 557-563. doi:10.1016/s0143-4004(96)80072-5
[35] Li DQ, Lokeshwar BL, Solomon A, et al. Regulation of MMP-9 production by human corneal epithelial cells[J]. Exp Eye Res, 2001, 73(4): 449-459. doi:10.1006/exer.2001.1054
[36] Golub LM, Ramamurthy NS, McNamara TF, et al. Tetracyclines inhibit connective tissue breakdown: new therapeutic implications for an old family of drugs[J]. Crit Rev Oral Biol Med, 1991, 2(3): 297-321. doi:10.1177/10454411910020030201
[37] Peng SX, VonBargen EC, Bornes DM, et al. Permeability of articular cartilage to matrix metalloprotease inhibitors[J]. Pharm Res, 1998, 15(9): 1414-1418. doi:10.1023/a: 1011905806123
[38] Cox SW, Eley BM, Kiili M, et al. Collagen degradation by interleukin-1beta-stimulated gingival fibroblasts is accompanied by release and activation of multiple matrix metalloproteinases and cysteine proteinases[J]. Oral Dis, 2006, 12(1): 34-40. doi:10.1111/j.1601-0825.2005.01153.x
[39] di Martino E, Ali M, Inglehearn CF. Matrix metalloproteinases in keratoconus-Too much of a good thing? [J]. Exp Eye Res, 2019, 182: 137-143. doi:10.1016/j.exer.2019.03.016
[40] Smith VA, Easty DL. Matrix metalloproteinase 2: involvement in keratoconus[J]. Eur J Ophthalmol, 2000, 10(3): 215-226. doi:10.1177/112067210001000305
[41] Kenney MC, Chwa M, Opbroek AJ, et al. Increased gelatinolytic activity in keratoconus keratocyte cultures. A correlation to an altered matrix metalloproteinase-2/tissue inhibitor of metalloproteinase ratio[J]. Cornea, 1994, 13(2): 114-124. doi:10.1097/00003226-199403000-00003
[42] Stuart KA, Riordan SM, Lidder S, et al. Hepatocyte growth factor/scatter factor-induced intracellular signalling[J]. Int J Exp Pathol, 2000, 81(1): 17-30. doi:10.1046/j.1365-2613.2000.00138.x
[43] Organ SL, Tsao MS. An overview of the c-MET signaling pathway[J]. Ther Adv Med Oncol, 2011, 3(1): S7-S19. doi:10.1177/1758834011422556
[44] Wilson SE, Walker JW, Chwang EL, et al. Hepatocyte growth factor, keratinocyte growth factor, their receptors, fibroblast growth factor receptor-2, and the cells of the cornea[J]. Invest Ophthalmol Vis Sci, 1993, 34(8): 2544-2561. doi: 10.1007/BF00919654
[45] Wilson SE, Liang Q, Kim WJ. Lacrimal gland HGF, KGF, and EGF mRNA levels increase after corneal epithelial wounding[J]. Invest Ophthalmol Vis Sci, 1999, 40(10): 2185-2190. doi: doi:10.1097/00004397-199903940-00012
[46] Burdon KP, Macgregor S, Bykhovskaya Y, et al. Association of polymorphisms in the hepatocyte growth factor gene promoter with keratoconus[J]. Invest Ophthalmol Vis Sci, 2011, 52(11): 8514-8519. doi:10.1167/iovs.11-8261
[47] Liu Y, Michalopoulos GK, Zarnegar R. Structural and functional characterization of the mouse hepatocyte growth factor gene promoter[J]. J Biol Chem, 1994, 269(6): 4152-4160. doi: 10.1016/0092-8674(94)90120-1
[48] De Benedetto A, Agnihothri R, McGirt LY, et al. Atopic dermatitis: a disease caused by innate immune defects? [J]. J Invest Dermatol, 2009, 129(1): 14-30. doi:10.1038/jid.2008.259
[49] Kallinikos P, Efron N. On the etiology of keratocyte loss during contact lens wear[J]. Invest Ophthalmol Vis Sci, 2004, 45(9): 3011-3020. doi:10.1167/iovs.04-0129
[50] Shneor E, Millodot M, Blumberg S, et al. Characteristics of 244 patients with keratoconus seen in an optometric contact lens practice[J]. Clin Exp Optom, 2013, 96(2): 219-224. doi:10.1111/cxo.12005
[51] Winkler M, Shoa G, Xie Y, et al. Three-dimensional distribution of transverse collagen fibers in the anterior human corneal stroma[J]. Invest Ophthalmol Vis Sci, 2013, 54(12): 7293-7301. doi:10.1167/iovs.13-13150
[52] Mackiewicz Z, Määtä M, Stenman M, et al. Collagenolytic proteinases in keratoconus[J]. Cornea, 2006, 25(5): 603-610. doi:10.1097/01.ico.0000208820.32614.00.
[53] Fodor M, Kolozsvári BL, Petrovski G, et al. Effect of contact lens wear on the release of tear mediators in keratoconus[J]. Eye Contact Lens, 2013, 39(2): 147-152. doi:10.1097/ICL.0b013e318273b35f
[54] Shoham A, Hadziahmetovic M, Dunaief JL, et al. Oxidative stress in diseases of the human cornea[J]. Free Radic Biol Med, 2008, 45(8): 1047-1055. doi:10.1016/j.freeradbiomed.2008.07.021
[55] Kenney MC, Brown DJ. The cascade hypothesis of keratoconus[J]. Contact Lens Anterior Eye, 2003, 26(3): 139-146. doi:10.1016/S1367-0484(03)00022-5
[56] Wojcik K A, Kaminska A, Blasiak J, et al. Oxidative stress in the pathogenesis of keratoconus and fuchs endothelial corneal dystrophy[J]. Int J Mol Sci, 2013, 14(9): 19294-19308. doi:10.3390/ijms140919294
[57] Gondhowiardjo TD, van Haeringen NJ, Völker-Dieben HJ, et al. Analysis of corneal aldehyde dehydrogenase patterns in pathologic corneas[J]. Cornea, 1993, 12(2): 146-154. doi:10.1097/00003226-199303000-00010
[58] Sharma N, Rao K, Maharana PK, et al. Ocular allergy and keratoconus[J]. Indian J Ophthalmol, 2013, 61(8): 407-409. doi:10.4103/0301-4738.116063
[59] Ahuja P, Dadachanji Z, Shetty R, et al. Relevance of IgE, allergy and eye rubbing in the pathogenesis and management of Keratoconus[J]. Indian J Ophthalmol, 2020, 68(10): 2067-2074. doi:10.4103/ijo.IJO_1191_19
[60] 夏艳云, 钟定娟, 王华, 等. 高能量加速型角膜胶原交联术对圆锥角膜眼表的影响[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 42-51. doi: 10.6040/j.issn.1673-3770.0.2021.432 XIA Yanyun, ZHONG Dingjuan, WANG Hua, et al. Effect of high-energy accelerated corneal collagen cross-linking on the ocular surface of keratoconus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 42-51. doi: 10.6040/j.issn.1673-3770.0.2021.432
[1] 王志远,郝忠凯,张晨明. 眼局部微压氧对兔角膜上皮细胞损伤后修复及氧化应激的影响[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 80-86.
[2] 李凯,罗丹. 润目灵方激活LC3-ATG5自噬通路抑制炎症因子表达改善干眼大鼠眼表损伤的机制[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 92-101.
[3] 顾敏,陆美萍. 纳米药物输送系统在变应性鼻炎过敏原免疫治疗中的应用进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 106-111.
[4] 段思妤,薛金梅. 组蛋白去乙酰化酶2在慢性气道炎症性疾病糖皮质激素抵抗中的研究进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 120-126.
[5] 李语辰,王旭. 巩膜镜治疗严重眼表疾病的有效性和安全性[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 149-154.
[6] 杜康丽,郑振宇,徐战将,张宇,陈露,卢梦垚. 鼻中隔偏曲并发慢性鼻窦炎风险预测模型的构建与验证[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 78-86.
[7] 高琳,何金梅,杨明祎. 糖尿病视网膜病变患者血清Sestrin2和NADPH氧化酶2水平与眼底病变的相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 113-117.
[8] 黄焕,华红利,邓玉琴,江承洋,王雨薇,杨星海. 儿童过敏性鼻炎、扁桃体腺样体肥大和鼻窦炎之间相关性及其对临床指导价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 34-41.
[9] 柯冰冰,陈铭,王洪阳,李春燕,殷善开. CAMK4介导胆红素所致听觉中枢神经元氧化应激损伤[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 1-10.
[10] 陈铭,柯冰冰,崔雅琦,吴翠萍,陈正侬,李春燕,殷善开. NAD+对顺铂所致毛细胞氧化应激损伤的拮抗作用及相关基因表达调控[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 11-18.
[11] 毛一恒,冯洁,何润田. 高血脂对视网膜损害与脉络膜厚度关系研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 162-167.
[12] 张杰,陈敏,申征征,吴宇华,刘原虎,孙浩,谭新华,倪树仁,杨书勋,史雪峥,倪鑫. 过敏性鼻炎与儿童新冠病毒肺炎感染及症状的关联性研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 36-42.
[13] 张丽净,冯晓星,刘南仙,赵辉明,陈月华. 石墨烯养护鼻罩结合尘螨的皮下特异性免疫治疗在尘螨变应性鼻炎患者中的应用分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 26-32.
[14] 张真,杨卓莹,周佳妮,张大为,陈仁杰. 环索奈德鼻喷剂治疗季节性过敏性鼻炎疗效与安全的Meta分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 13-20.
[15] 乌日柴夫,苏日古格,孟永梅. 卵清蛋白诱导的过敏性鼻炎豚鼠模型的建立与评价及蒙医舌尿诊的初步分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 32-38.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!