百年校庆

间歇性禁食减轻内毒素诱导小鼠葡萄膜炎的研究

Research on intermittent fasting attenuates endotoxin-induced uveitis in mice

:501-512
 
目的:探究间歇性禁食(intermittent fasting, IF)对内毒素诱导小鼠葡萄膜炎(endotoxin-induced uveitis, EIU)的保护作用及其可能的抗炎机制。方法:小鼠随机分为对照组、EIU组及IF+EIU组。16∶8禁食方案(9 : 00—17 : 00进食)。对照组行玻璃体腔内注射磷酸盐缓冲溶液(phosphate buffered saline, PBS),其余两组行玻璃体腔内脂多糖注射。建模后监测小鼠空腹血糖及体质量。光学相干断层扫描和苏木精伊红染色观察评估炎症水平。视网膜铺片行神经炎症相关的观察评价。BV2细胞分为Ctr组,LPS组及饥饿+内毒素组,蛋白印迹及实时荧光定量逆转录PCR技术检测相关蛋白及mRNA表达水平。结果:①IF对体质量无明显影响,可引起血糖显著降低随后逐渐恢复。病程中期起IF干预下小鼠视网膜水肿恢复,玻璃体腔内炎性渗出比EIU组显著减少(P<0.01)。IF逆转LPS诱导的小胶质细胞激活,减轻视网膜神经节细胞及神经纤维损伤(P<0.05)。②饥饿培养抑制LPS诱导的BV2细胞的磷酸化信号转导与转录激活因子1和3及诱导型一氧化氮合酶( inducible nitric oxide synthase, iNOS)的蛋白表达水平(P<0.05),显著降低iNOS、白介素-6等炎症因子的表达水平。结论:IF能够加速EIU炎症的消退,减轻组织结构的炎性破坏,抑制小胶质细胞的促炎型激活。

Objective: To investigate the protective effects of intermittent fasting (IF) on endotoxin-induced uveitis in mice and its potential anti-inflammatory mechanisms. Methods: Mice were randomly divided into three groups: control group (Ctr), endotoxin-induced uveitis (EIU) group, and IF + EIU group. The IF regimen followed a 16:8 fasting scheme (feeding from 9:00 to 17:00). The control group received intravitreal injections of PBS, while the other two groups received intravitreal injections of lipopolysaccharide (LPS). After modeling, fasting blood glucose and body weight of the mice were monitored. Inflammation levels were assessed using OCT and H&E staining. Retinal flat mounts were used for evaluating neuroinflammation. BV2 cells were divided into Ctr group, LPS group, and starvation (LG) + LPS group. The expression levels of related proteins and mRNA were detected using WB and RT-qPCR. Results: IF had no significant effect on body weight but caused a significant decrease in blood glucose, which gradually recovered. From the middle stage of the disease, mice in the IF intervention group show edretinal edema recovery, significantly reduced intravitreal inflammatory exudation and cell infiltration compared to the EIU group (<0.01). IF reversed LPS-induced microglial activation and significantly alleviated damage to retinal ganglion cells and nerve fibers (P <0.05). Starvation culture significantly inhibited LPS-induced expression levels of p-STAT1/3 and iNOS proteins in BV2 cells (P <0.05) and significantly reduced the expression levels of inflammatory factors such as iNOS and IL-6. Conclusion: IF can accelerate the resolution of EIU inflammation, reduce inflammatory damage to tissue structures, and inhibit pro-inflammatory activation of microglia.
眼底影像专栏

非感染性葡萄膜炎继发脉络膜新生血管的多模式影像特征

Multimodal imaging features of choroidal neovascularization secondary to non-infectious uveitis

:241-251
 
目的:评估炎非感染性葡萄膜炎继发炎性脉络膜新生血管(inflammatory choroidal neovascularization, iCNV)的临床特征及眼底多模式影像表现。方法:采用回顾性观察性研究,采用眼底荧光素血管造影(fundus fluorescein angiography, FFA)、吲哚菁绿血管造影(Indocyanine green angiography, ICGA)、谱域相干光断层扫描(spectral domain optical coherence tomography, SD-OCT)联合光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)等多种眼底影像学方法,对纳入患者的眼底进行检查,分析非感染性iCNV的面积、分型、位置及形态等影像学特征与临床特征的关系。结果:研究共纳入39例患者,对48只患眼中的51处iCNV病灶进行了评估。纳入患者年龄为(35.28±13.62)岁。其中3例患眼出现多灶性CNV。SD-OCT显示92.16%(47/51)的iCNV为2型CNV,17.65%(9/51)的iCNV出现海绵征,13.72%(7/51)的iCNV伴有局灶脉络膜凹陷。ICGA造影期间,74.50%的iCNV病灶(38/51)伴有弱荧光病灶,25.49%的病例(13/51)显示脉络膜高通透性表现。OCTA enface图像显示iCNV形态多样,包括焦点状(15例,29.41%)、盘状/海扇状(16例,31.37%)、枯树状(9例,17.65%)、星状(9例,17.65%)及弥漫网状(2例,3.92%)。其中,枯树状及星状iCNV提示iCNV为非活动性(P<0.01)。结论:非感染性iCNV与炎性病灶关系密切,在SD-OCT,ICGA上皆具特征性的影像表现。OCTA能直观地观察到iCNV的形态。这些多模式影像特征为临床医生提供了对于非感染性iCNV重要的鉴别诊断依据,有助于制定有效的诊疗方案。
Objective: To evaluate the clinical characteristics and multimodal imaging features of non-infectious inflammatory choroidal neovascularization (iCNV). Methods: In this study retrospective, observational study, multimodal imaging examinations, including fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA), were used to observe the morphology of non-infectious iCNV in patients diagnosed with uveitis. The area of iCNV, CNV types, CNV morphology and other imaging characteristics were further analyzed. Results: A total of 39 patients were included, with 48 affected eyes and 51 iCNV were identified. The average age of the included patients was 35.28±13.62 years. Among the affected eyes, 3 presented with multifocal CNV, and 92.16% of iCNV were classified as type 2 CNV. iCNV exhibited diverse morphologies, including focal-like pattern (15 cases, 29.41%),sea-fan pattern(16 cases, 31.37%), dead-tree pattern CNV(9 cases, 17.65%), stellar pattern (9 cases, 17.65%), and diffuse reticular (2 cases, 3.92%). Notably, tree-like and stellar pattern iCNV showed a significant correlation with non-active CNV (P < 0.01). Conclusions: Non-infectious iCNV is closely related to inflammatory lesions, exhibiting characteristic imaging features on SD-OCT and ICGA. OCTA allows for direct observation of the morphology of iCNV. These multimodal imaging characteristics provide important diagnostic criteria for clinicians, aiding in the formulation of effective treatment plans.
论著

白塞病性葡萄膜炎并发视网膜新生血管的临床及影像学特征分析

Clinical and imaging characteristics of retinal neovascularization secondary to Behçet's uveitis

:103-112
 

目的:探讨白塞病性葡萄膜炎(Behçet's uveitis, BU)并发视盘新生血管(neovascularization of the optic disc, NVD)和(或)视盘以外视网膜新生血管(retinal neovascularization elsewhere, NVE)的临床及影像特征。方法:回顾性分析2022年1月—2024年9月就诊的BU并发NVD和(或)NVE患者的临床资料和眼底影像学检查结果,包括眼底彩照、荧光素眼底血管造影(fluorescein fundus angiography, FFA)、光学相干断层成像(optical coherence tomography, OCT)和光学相干断层血管成像(OCT angiography, OCTA)。并分析NVD和(或)NVE面积与患眼的改良的眼后段炎症评分以及视网膜血管渗漏评分的相关性。结果:共纳入27例患者(30只眼),年龄为(27.70±12.58)岁,男女比例约为1:1。3例(11%)患者双眼并发NVD和(或)NVE;25只眼(83%)存在NVD:17只眼(57%)仅有NVD;8只眼(27%)存在NVD和NVE。仅2只眼(7%)存在视网膜无灌注区,7只眼(23%)同时发生玻璃体积血。FFA眼后段炎症评分为(20.93±4.37)分。FFA血管渗漏评分为(7.57±1.25)分。NVD和(或)NVE面积与眼后段炎症评分(rs = 0.403,P = 0.027)及视网膜血管渗漏评分(rs 0.518,P = 0.003)均呈正相关。FFA与OCTA在检测NVD和NVE上表现完全一致(κ= 1.0)。结论:BU并发NVD和(或)NVE并不罕见,以NVD为主,绝大多数与视网膜无灌注不相关,可能由BU炎症诱发。

Purpose: To investigate the clinical and imaging characteristics of retinal neovascularization of the optic disc (NVD) and/or elsewhere in the retina (retinal neovascularization elsewhere, NVE) in eyes with Behçet's uveitis (BU). Methods: This retrospective analysis reviewed the clinical data and fundus imaging findings of patients diagnosed with BU complicated by NVD and/or NVE from January 2022 to September 2024. Imaging modalities included fundus photography, fluorescein fundus angiography (FFA), optical coherence tomography (OCT), and OCT angiography (OCTA). The study analyzed the correlation between the areas of NVD and/or NVE and the modified posterior segment inflammation scores, as well as retinal vascular leakage scores of the affected eyes. Results: The study included 27 patients (30 eyes) with an average age of (27.70 ± 12.58) years and a gender ratio of approximately 1:1. Bilateral NVD and/or NVE was observed in three patients (11%); 25 eyes (83%) had NVD, of which 17 eyes (57%) had only NVD and 8 eyes (27%) had both NVD and NVE. Two eyes (7%) showed areas of retinal non-perfusion, and seven eyes (23%) had concurrent vitreous hemorrhage. The average score for posterior segment inflammation on FFA was 20.93 ± 4.37, and the average score for vascular leakage was 7.57 ± 1.25. There was a significant positive correlation between the area of NVD and/or NVE and both the inflammation score (rs = 0.403, P = 0.027) and the vascular leakage score (rs = 0.518, P = 0.003). FFA and OCTA showed perfect agreement in detecting NVD and NVE (κ = 1.0). Conclusion: NVD and/or NVE in BU are not uncommon and are predominantly presented as NVD, mostly not associated with retinal nonperfusion, likely induced by inflammatory factors related to BU.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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