淋巴管在眼病发病机理中的新角色。
The novel role of lymphatic vessels in the pathogenesis of ocular diseases.
发表日期：2023 Feb 07
作者：
Thomas Clahsen, Karina Hadrian, Maria Notara, Simona L Schlereth, Antonia Howaldt, Verena Prokosch, Thomas Volatier, Deniz Hos, Falk Schroedl, Alexandra Kaser-Eichberger, Ludwig M Heindl, Philipp Steven, Jacobus J Bosch, Alexander Steinkasserer, Alexander C Rokohl, Hanhan Liu, Mert Mestanoglu, Hamid Kashkar, Björn Schumacher, Friedemann Kiefer, Stefan Schulte-Merker, Mario Matthaei, Yanhong Hou, Sonja Fassbender, Jonathan Jantsch, Wei Zhang, Philip Enders, Björn Bachmann, Felix Bock, Claus Cursiefen
来源：
PROGRESS IN RETINAL AND EYE RESEARCH
摘要：
从历史上看，眼睛被认为是没有淋巴管组织的器官。然而，近年来已经明确，淋巴管或类似淋巴管的组织在各种眼部病理学中具有作用，分布在不同的眼部区域。本综述的目的是概述眼部淋巴管的病理发病作用、相关分子机制，并探讨当前和未来的治疗选择。我们将概述健康眼表面的血管解剖学及贡献于角膜淋巴造血特权的分子机制。此外，我们介绍（i）病理性角膜新生血管形成的细胞和分子机制、如由炎症或创伤引起的、（ii）淋巴管对于不同眼表病理学的作用，如干眼症、角膜移植排异、眼部移植物抗宿主病、过敏和眼翼状物、（iii）淋巴管在眼部肿瘤和转移中的作用，以及（iv）Schlemm氏小管类似淋巴结构在青光眼中的新角色。找到潜在的分子机制和淋巴造血新调节因子将有助于未来治疗与病理性淋巴造血相关的眼部疾病的新治疗靶标的开发。本文所述的临床前数据概述了一些新的治疗概念，包括促进移植物存活、抑制眼部肿瘤转移、减轻眼表面的炎症和治疗青光眼。临床试验的初步数据表明，在预移植的角膜淋巴消退基础上促进移植物存活的新治疗策略已初见成效。Copyright © 2023 Elsevier Ltd. All rights reserved.
Historically, the eye has been considered as an organ free of lymphatic vessels. In recent years, however, it became evident, that lymphatic vessels or lymphatic-like vessels contribute to several ocular pathologies at various peri- and intraocular locations. The aim of this review is to outline the pathogenetic role of ocular lymphatics, the respective molecular mechanisms and to discuss current and future therapeutic options based thereon. We will give an overview on the vascular anatomy of the healthy ocular surface and the molecular mechanisms contributing to corneal (lymph)angiogenic privilege. In addition, we present (i) current insights into the cellular and molecular mechanisms occurring during pathological neovascularization of the cornea triggered e.g. by inflammation or trauma, (ii) the role of lymphatic vessels in different ocular surface pathologies such as dry eye disease, corneal graft rejection, ocular graft versus host disease, allergy, and pterygium, (iii) the involvement of lymphatic vessels in ocular tumors and metastasis, and (iv) the novel role of the lymphatic-like structure of Schlemm's canal in glaucoma. Identification of the underlying molecular mechanisms and of novel modulators of lymphangiogenesis will contribute to the development of new therapeutic targets for the treatment of ocular diseases associated with pathological lymphangiogenesis in the future. The preclinical data presented here outline novel therapeutic concepts for promoting transplant survival, inhibiting metastasis of ocular tumors, reducing inflammation of the ocular surface, and treating glaucoma. Initial data from clinical trials suggest first success of novel treatment strategies to promote transplant survival based on pretransplant corneal lymphangioregression.Copyright © 2023 Elsevier Ltd. All rights reserved.