背景原发性开角型青光眼的病变部位主要位于小梁网和Schlemm管，小梁网作为眼内房水的主要排出通道，其组织特性及组织来源仍存在争议，探讨小梁网内皮的细胞属性可为原发性开角型青光眼的治疗提供新的思路。
目的研究人眼小梁网中淋巴管内皮标志物D2-40和血管内皮细胞标志物CD31、CD34和平滑肌肌动蛋白(SMA)的表达，探讨小梁网的组织特性及来源。
方法收集中山大学中山眼科中心病理科保存的20例前房角开放且房角结构正常的成人眼球标本，包括因外伤大失血死亡的供体眼球标本10例、眼后节黑色素瘤手术摘除眼球标本3例和眶内容物摘除的眼球标本7例。所有眼球标本沿子午线方向进行4 μm厚连续切片，行常规组织病理学检查以观察前房角、小梁网和Schlemm管的组织结构，并采用免疫组织化学染色观察D2-40、CD31、CD34和SMA在小梁网和Schlemm管组织中的表达。
结果眼球组织切片中可见完整的房角结构，小梁网呈网状，Schlemm管呈无色的空腔，未见异常物质的沉积及周边组织粘连。20例眼球标本中可见小梁网内皮细胞中D2-40均呈强阳性表达，呈棕褐色染色，表达强度均为3分，而CD31、CD34和SMA表达阴性；Schlemm管内皮细胞中D2-40呈阴性表达，而CD31和CD34染色呈强阳性表达。小梁网邻近组织中血管内皮细胞可见CD31和CD34染色呈强阳性。
结论小梁网组织表达淋巴管内皮标志物D2-40，但不表达血管内皮细胞标志物，提示小梁网属于淋巴管样组织。
BackgroundThe pathological basis of human primary open angle glaucoma mainly is the degeneration of trabecular meshwork and Schlemm canal.As the outflow pathway of aqueous humor, the tissue origin and characteristics of trabecular meshwork remain less clear.Studying the characteristics of trabecular meshwork may contribute a new thought to the treatment of primary open angle glaucoma.
ObjectiveThis study was to explore the histological property of trabecular meshwork by detecting the expression of D2-40, a lymphatic biomarker, and CD31, CD34 and smooth muscle actin (SMA), some vascular endothelial biomarkers.
MethodsTwenty specimens of adult eyeballs were collected from Zhongshan Ophthalmic Center of Sun Yat-sen University, including 10 eyeballs from accident death donors, 3 enucleated eyeballs due to posterior segment of choroidal malignant melanoma and 7 orbital exenterated eyeballs.The series ocular meridian sections with the thickness of 4 μm were prepared for the haematoxylin-eosin staining.Immunohistochemistry was employed to detect the expression of D2-40, CD31, CD34 and SMA in trabecular meshwork and Schlemm canal.
ResultsIntact structure of chamber angle was observed under the optical microscope by haematoxylin-eosin staining.Human trabecular meshwork tissue was presented with mesh-like structure, while Schlemm canal showed the lumen structure.No abnormal substance and periphery synechia were found.D2-40 was strongly expressed in the trabecular meshwork endothelial cells with staining score for 3 points, but CD31, CD34 and SMA were negatively expressed.In contrast, CD31, CD34 and SMA rather than D2-40 were positively expressed in the Schlemm canal.In addition, CD31 and CD34 were also positively expressed in the vascular endothelial cells around the trabecular meshwork.
ConclusionsThe trabecular meshwork expresses lymphatic biomarker rather than vascular biomarkers.This result indicates that trabecular meshwork of human eyes is lymphatic vessel-like tissue.
万尚韬,李永平,张平,等. 淋巴管内皮标志物D2-40在人眼小梁网的表达[J]. 中华实验眼科杂志,2015,33(10)：892-895.
DOI:10.3760/cma.j.issn.2095-0160.2015.10.006版权归中华医学会所有。
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