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Background Researches indicated that etiology and epidemiology of pertussis toxin (PTX)dependent experimental autoimmune uveoretinitis(EAU)model are very different with human uveoretinitis owing to the influence of PTX on immune.Our previous study has established lipopolysaccharide (LPS),an endotoxin,which instesad of PTX,mediated EAU model.However,the exact roles of LPS and PTX in EAU still remained unclear.Objective This study was to investigate the roles of LPS and PTX in EAU model.Methods Twenty SPF C57BL/6(H-2b) mice were assigned to 0 d-PTX-EAU group,7 d-PTX-EAU group,0 d-LPS-EAU group and 7 d-LPS-EAU group using random number table method.The mice were immunized with interphotoreceptor retinoid-binding protein 1-20(IRBP 1-20) emulsified in complete Freund adjuvant (CFA),and concurrently with or on day 7 postimmunization,LPS or PTX was injected in the footpad or intraperitoneally respectively.Delayed-type hypersensitivity (DTH) of the mice was evaluated by measuring the ear thickness 48 hours after IRBP was injected into the ear pinna,and lymphocyte proliferation was assessed by tritiated thymidine uptake.Retinal histopathological examination was performed and scored based on criteria of Caspi.The use and care of experimental animals complied with Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Serious infiltration of inflammatory cells,disorder of entire retinal structure and retinal folds were seen in the mice of the 0 d-PTX-EAU group and 7 d-LPS-EAU group on 21 days after injection of PTX or 14 days after injection of LPS,and severe vitritis and a few granuloma-like lesions were found in the 0 d-PTX-EAU group.However,only mild vasodilatation or less retinal folds were found in the 7 d-PTX-EAU group and 0 d-LPS-EAU group.The pathological scores in the mice of the 0 d-PTX-EAU group and 7 d-LPS-EAU group were higher than those of the 7 d-PTX-EAU group and 0 d-LPS-EAU group (all at P ＜ 0.05).The ear thickness was (62.600 ± 3.362) μm,(60.000±2.345) μm,(30.400± 1.817) μm and (32.800 ± 1.643) μm in the 0 d-PTX-EAU group,7 d-PTX-EAU group,0 d-LPS-EAU group and 7 d-LPS-EAU group,showing a significantly difference among the 4 groups (Fgroup =259.751,P=0.000),and the ear thicknesses of 0 d-PTX-EAU group and 7 d-PTX-EAU group were significantly higher than those of the 0 d-LPS-EAU group and 7 d-LPS-EAU group (all at P＜0.05).The lymphocyte proliferation was strongly enhanced in PTX-EAU groups,and the radiation count per minute (cpm) was (16 150.000±799.218)/min and (16 120.000±729.383)/min in the 0 d-PTX EAU group and 7 d-PTX EAU group,and (8 348.000±258.979)/min and (8 540.000±81.548)/min in the 0 d-LPS EAU group and 7 d-LPS EAU group respectively,with a significant difference among the PTX-EAU groups and LPS-EAU groups (Fgroup =316.978,P=0.000).Conclusions LPS and PTX play different roles during the EAU formation.LPS may be involved in the breakdown of blood-retina barriers (BRB).
ABSTRACT
Background The pathogenesis and management of human autoimmunity uveoretinitis is a focus in ophthalmology.For decades,a traditional experimental autoimmunity uveoretinitis (EAU) induced by pertussis toxin (PTX) was used for the basic investigation,which was thought to have a large deviation from the natural course of human autoimmunity uveoretinitis.Objective This study was to establish a new mice model of autoimmunity uveoretinitis which mimics the human autoimmunity uveoretinitis pathogenesis and offer a basis for the investigation and treatment of uveoretinitis.Methods Twenty 6-8 weeks old specific pathogen-free female C57BL/6 (H-2b) mice were randomized into normal control group,only endotoxin (lipopolysaccharide,LPS) induced uveitis group (endotoxin induced uveitis [EIU] group),interphotoreceptor retinoid-binding protein (IRBP1-20) +complete Freund adjuvant (CFA) induced uveoretinitis group (EAU group) and IRBP+CFA+LPS induced uveoretinitis group (LPS-EAU group).The mice of the EAU were only immunized with IRBP emulsified in CFA,and LPS-EAU group firstly were immunized with IRBP emulsified in CFA and then LPS was injected in the footpad of the mice on 7 days following immunization.The ocular pathological examination,histopathological scoring,delayed-type hypersensitivity and specific lymphocyte proliferating response were evaluated and compared with the EIU models,traditional EAU models without PTX and LPS-EAU models.The use and care of experimental animals complied with Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results No inflammatory response was found in the iris,cilliary body and retina of mice in the normal control group.However,mild blood vessels dilation and fibrin exudation were seen in the iris and cilliary body of mice in the EIU group.In the EAU group,mild vasculitis and swelling of nerve fiber layer were exhibited in the retinas; while in the LPS-EAU group,severe disorder of retinal structure,infiltration of inflammatory cells and damage of photoreceptor were found under the optical microscope.The pathological score was 0 in the models of the normal control group and EIU group,0.5 score in the EAU group and 3.0 scores in the LPS-EAU group,with a significant difference in the pathological scores between the EAU group and the LPS-EAU group (U=16.246,P =0.001).The earthickness of the mice was (35.60±0.55) μm in the LPS-EAU group,and this value was significantly higher than (12.60±0.55) μm of the EIU group (q =23.003,P＜0.01),but closed to (34.80±0.84) μm of the EAU group (t =0.820,P＞0.05).The obvious cloning were seen and theradiation count per minute was (8 540.00 ±54.77)/min in the model mice of the LPS-EAU group,and that in the EAU group was (8 484.00±47.75)/min,without significant difference between them (q =56.634,P =0.069).Compared with the β particle number (2 050.00±50.00)/min in the EIU group,that of the LPS-EAU group was significantly elevated (q =195.683,P =0.000).Conclusions LPS injection can induce EAU in mice,and this model can better imitate the pathogenesis of human autoimmunity uveoretinitis.
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Objective To evaluate the clinical effect of the procedure that involves drilling and inserting a motility peg at the time of hydroxyapatite orbital implant.Methods 89 patients who needed hydroxyapatite orbital implant were divided into groups A and B.The patients in group A were drilled and inserted a motility titanium peg when hydroxyapatite implantation.The patients in group B were drilled and inserted a motility titanium peg 6 months after hydroxyapatite implantation.Data were recorded.including the rate of postoperative pain and conjunctive edema,postoperative facial appearance,motility of the artifieial eye,the rate of hydroxyapatite exposure,excursion and extrusion of titanium peg and other complications.Results The mobility of the prosthesis was 44.97%in group A,and 45.34%in group B.There was no difference in appearance and the motility of their artificial eye between the two groups.The rate of excursion of titanium peg was 4.2% in group A and 7.3%in group B and no statistical difference was found between the two groups.There were no prosthesis exposure,extrusion of titanium peg,secondary infeetion and other complication in one-year follow-up.There were no difference in the rate of postoperative pain and eonjunctive edema in first operative stage.The postoperative reaction in group A was lighter than that in group B in secondary operanve stage.Conclusion The hydroxyapatite orbital implant primary procedure drilling is simple,safe,convenient and effective.It is worth to recommend that procedure that involves drilling and inserting a motility peg at the time of hydroxyapatite orbitaI primary implant.
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Objective To evaluate the application of the polymethyl methacrylate (PMMA) artificial eye in acquired ophthalmostewesis. Methods We summarized the experience in the application of PMMA in prosthesis for 8 years. 1155 patients were involved in the artificial eye custom-made program. The artificial eye was individually prepared based on the patient's condition and characters of the healthy eye.Results PMMA artificial eye associated with hydroxyl apatite implantation gave good cosmetic results with good motility, and there was no rejective reaction. The artificial eye was almost same to the real one in color and transparency. Conclusion It is suggested that PMMA is one of the best materials for manufacture of artificial eye at present.
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Objective To evaluate the clinical effect of Medpor ( porous high density polyethylene )as a padding material in correction of sunken eyelid after hydroxyapatite (HA) implantation. Methods We used Medpor in 17 patients ( 10 male and 7 female ), aged from 18 to 43 years (mean 26.6 years ), in which 9 cases had concomitant orbital fractures. The Medpor was implanted after HA sphere implantation ranged from 2 to 19 months ( average 6.7 months ). 17 consecutive patients with implantation of HA sphere were filled with Medpor under the periosteum. All of the cases were examined by CT scanning to distinguish orbital lesions with or without fracture. In the orbital fracture cases, we first repaired orbit bone defects with Medpor. Results There were no secondary infection or implant rejection occurred after following up for 1 to 18 months (average 8.7 months ). All patients' cosmesis was acceptable. 14 of 17 patients gained symmetric appearance. Although 3 patients had slight sunken eyelid, they gained a dramatic improvement of facial appearance nevertheless. Conclusions Sunken eyelid after HA sphere implant is related with orbital fracture as well as relative reduction of orbital content. Medpor presents fine biological compatibility. It is also easy to remodel and fix during operation. Medpor is a good implant for treatment of sunken eyelid after HA sphere orbital implantaion. [
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Objective To evaluate the middle and long term effects of the two-stage procedures of drilling for hydroxyapatite orbital implant and inserting a motility peg, and to investigate the pathogenesis and treatment of the various complications during the procedure. Methods This retospective study included 68 patients who had underwent the drilling of the hydroxyapatite and motility peg placement for over 3 years. Mean age at operation was 30.7 years (range from 17～60 years). All patients were placed plastic peg. Information recorded included pre-and post-operative facial appearance, motility of the artificial eye, conjunctival sac discharge and other complications. Results No secondary infection occured in 36～72 months of follow up. All patients felt that there had been an improvement in the motility of their artificial eye. And their cosmetic appearance was acceptable. The most frequent complication encountered was discharge from conjunctiva sac, which occurred in 31 patients. Extrusion of the motility peg was found in 6 patients. 5 patients had exuberant granulation in conjunctiva sac. Conclusion Drilling of the hydroxyapatite implant improves both the appearance and the motility of the artificial eye. Complications are minor and can be easily prevented and treated. The vascularization of HA sphere with good motility should be drilled at relatively larger conjunctival sac in the patients who can cooperate under local anesthesia.