Mechanisms involved in the side effects of glucocorticoids

eMedicine创建于1996年，由近万名临床医师作为作者或编辑参与此临床医学知识库的建设，其中编辑均是来自美国哈佛、耶鲁、斯坦福、芝加哥、德克萨斯、加州大学等各分校医学院的教授或副教授。

eMedicine

The multifunctional choroid.

The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease. Its central mechanism is evaporative water loss leading to hyperosmolar tissue damage. Research in human disease and in animal models has shown that this, either directly or by inducing inflammation, causes a loss of both epithelial and goblet cells. The consequent decrease in surface wettability leads to early tear film breakup and amplifies hyperosmolarity via a Vicious Circle. Pain in dry eye is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity. Increased friction targets damage to the lids and ocular surface, resulting in characteristic punctate epithelial keratitis, superior limbic keratoconjunctivitis, filamentary keratitis, lid parallel conjunctival folds, and lid wiper epitheliopathy. Hybrid dry eye disease, with features of both aqueous deficiency and increased evaporation, is common and efforts should be made to determine the relative contribution of each form to the total picture. To this end, practical methods are needed to measure tear evaporation in the clinic, and similarly, methods are needed to measure osmolarity at the tissue level across the ocular surface, to better determine the severity of dry eye. Areas for future research include the role of genetic mechanisms in non-Sjogren syndrome dry eye, the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation.

TFOS DEWS II pathophysiology report

Age-related macular degeneration: etiology, pathogenesis, and therapeutic strategies.

A pupillary membrane in a case of congenital pupillary-iris-lens membrane with goniodysgenesis was surgically peeled from the lens without causing cataract formation. Histopathology revealed ectopic iris. The ectopic iris found in this condition differentiates congenital pupillary-iris-lens membrane with goniodysgenesis as an entity from persistent pupillary membrane, hereditary goniodysgenesis, and Rieger's anomaly. We suggest that congenital pupillary-iris-lens membrane with goniodysgenesis is a neurocristopathy. The finding of ectopic iris muscle is consistent with avian chimera experiments that have suggested that iris sphincter muscle is derived from the neural crest, not neural ectoderm. Membranes in this condition can be successfully removed when they cause vision loss and amblyopia.

Surgical removal of congenital pupillary-iris-lens membrane.

Fibroblast growth factor (FGF) is a monomeric mitogenic protein that exists as an acidic and a basic form and is distributed widely in tissues of the eye. Because FGF interacts with the cells and with the extracellular matrix, it has potential as a therapeutic agent, either alone or in combination with other agents such as epidermal growth factor, in promoting healing of corneal wounds, in restoring corneal endothelial cell loss due to dystrophic, degenerative, and surgical insults, as well as in regenerating lens cells after cataract surgery. Excess FGF probably plays a significant role in the pathogenesis of blinding disorders of the eye such as neovascular glaucoma, age-related macular degeneration, and proliferative diabetic vitreoretinopathy, as well as failure of surgical filtering procedures for glaucoma. The use of transforming growth factor-beta, anti-FGF antibodies, and other blocking agents in the treatment of such diseases seems logical.

Fibroblast growth factor in the eye and prospects for its therapeutic use

Radioimmunoassay of epidermal growth factor in human lenses at various stages of development of cataract.

Purpose. To investigate alterations in the proteoglycan (PG) and glycosaminoglycan (GAG) content of the aqueous humour in patients with pseudoexfoliation syndrome (PEX). Materials and methods. Aqueous humor samples were obtained during cataract surgery from nineteen patients bearing PEX features and twenty-three age-matched normal controls. Protein and IgG were quantified densitometrically after their electrophoretic separation. Collagen type IX, 3-sulphoglucuronic acid (HNK-1 epitope), biglycan and heparan sulphate proteoglycans were detected in Western and dot blots by using specific monoclonal antibodies (MAbs). The immunochemical analysis was performed in native aqueous humour or after degradation of the glycosaminoglycans with chondroitinases. Results. Degradation of the samples with chondroitinases ABC, AC and B revealed that, in the aqueous humour from PEX eyes, collagen type IX and biglycan had a more dermatan sulphate than did normal eyes. In addition, more HNK-1 epitope was observed in PEX eyes,...

Brenda J. Tripathi

Papers

Surgical removal of congenital pupillary-iris-lens membrane.

Fibroblast growth factor in the eye and prospects for its therapeutic use

Radioimmunoassay of epidermal growth factor in human lenses at various stages of development of cataract.

Changes in HNK-1 epitope and collagen type IX in the aqueous humour of patients with pseudoexfoliation syndrome.

Detection of glycated polypeptides in human aqueous humor by lectin-binding analysis.