張文佳 胡竹林 朱勤 韋春玲 孫曉梅 代解杰 劉海 楊忠昆
【實(shí)驗(yàn)研究】
人臍靜脈血管內(nèi)皮細(xì)胞在體移植替代猴角膜內(nèi)皮細(xì)胞的形態(tài)學(xué)分析△
張文佳 胡竹林 朱勤 韋春玲 孫曉梅 代解杰 劉海 楊忠昆
血管內(nèi)皮細(xì)胞;角膜內(nèi)皮細(xì)胞;恒河猴
目的 使用去除后彈力層的恒河猴自體角膜為細(xì)胞載體,將培養(yǎng)的人臍靜脈血管內(nèi)皮細(xì)胞(human umbilical vein endothelial cells,HUVEC)種植到角膜內(nèi)表面,觀察HUVEC替代恒河猴角膜內(nèi)皮細(xì)胞的功能情況以及HUVEC在恒河猴眼內(nèi)生長的情況。方法 取恒河猴6只隨機(jī)分為3組:實(shí)驗(yàn)組(3只)、實(shí)驗(yàn)對照組(2只)、空白對照組(1只)。實(shí)驗(yàn)組:用離心沉淀法將培養(yǎng)的HUVEC移植到去除后彈力層的恒河猴自體角膜內(nèi)表面,之后將自體角膜縫回植床;實(shí)驗(yàn)對照組:將撕除部分后彈力層的術(shù)眼角膜植片原位縫回植床;空白對照組:取下術(shù)眼角膜植片不做任何處理原位縫回植床。術(shù)后觀察各組角膜植片透明情況;實(shí)驗(yàn)組及實(shí)驗(yàn)對照組于術(shù)后30 d及60 d、空白對照組于術(shù)后60 d行術(shù)眼摘除,標(biāo)本做病理切片、CD34免疫組化及掃描電鏡,觀察房角結(jié)構(gòu)及HUVEC在角膜植片內(nèi)表面形態(tài)分布。結(jié)果 實(shí)驗(yàn)組角膜植片維持了一定的厚度和透明性,而實(shí)驗(yàn)對照組角膜植片發(fā)生嚴(yán)重大泡性改變。病理切片示實(shí)驗(yàn)組角膜內(nèi)表面可見一層細(xì)胞生長,CD34染色陽性,提示為血管內(nèi)皮細(xì)胞;實(shí)驗(yàn)對照組角膜內(nèi)表面未見任何細(xì)胞生長;空白對照組角膜植片保留完整后彈力層及內(nèi)皮細(xì)胞層。掃描電鏡示實(shí)驗(yàn)組有HUVEC單層在角膜內(nèi)表面生長但有大量白細(xì)胞聚集及少量細(xì)胞碎片嵌頓于小梁網(wǎng);實(shí)驗(yàn)對照組角膜內(nèi)表面殘留膠原纖維樣物質(zhì),無細(xì)胞生長;空白對照組見完整六邊形角膜內(nèi)皮細(xì)胞層。結(jié)論 HUVEC能夠在撕除后彈力層的恒河猴角膜內(nèi)表面生長并發(fā)揮一定的屏障作用,維持角膜的厚度和透明性,但會產(chǎn)生較重的排斥反應(yīng)。
[眼科新進(jìn)展,2014,34(11):1020-1024]
角膜內(nèi)皮層的完整和功能健全是維持角膜的正常厚度及透明性的重要因素。靈長目動(dòng)物(包括人類)的角膜內(nèi)皮細(xì)胞(corneal endothelial cell,CEC)屬于終末細(xì)胞,正常情況下無分裂能力,多種原因可導(dǎo)致角膜內(nèi)皮受損,引起大泡性角膜病變,導(dǎo)致患眼疼痛乃至失明。鑒于新鮮角膜植片匱乏的現(xiàn)狀,穿透性角膜移植術(shù)難以廣泛開展,目前國內(nèi)外針對角膜內(nèi)皮受損治療研究熱點(diǎn)是角膜內(nèi)皮移植術(shù),但是CEC的來源仍然成為其制約因素。尋找有效的CEC功能替代細(xì)胞可能將成為新的研究方向。本實(shí)驗(yàn)利用血管內(nèi)皮細(xì)胞(vascular endothelial cell,VEC)與CEC具有結(jié)構(gòu)和功能上的相似性和各自的特點(diǎn),直接以自體角膜基質(zhì)為載體,利用人臍靜脈血管內(nèi)皮細(xì)胞(human umbilical vein endothelial cells,HUVEC)進(jìn)行恒河猴CEC替代移植,取得了可喜的效果,為細(xì)胞替代移植開拓了新的思路。
1.1 實(shí)驗(yàn)動(dòng)物 實(shí)驗(yàn)用成年恒河猴6只,年齡5~10歲,體質(zhì)量3.0~5.0 kg,雌雄兼有,由中國醫(yī)學(xué)科學(xué)院中國協(xié)和醫(yī)科大學(xué)醫(yī)學(xué)生物學(xué)研究所靈長類研究中心提供,實(shí)驗(yàn)前動(dòng)物行血液、尿液、糞便三大常規(guī)檢測、血生化檢測、心電圖監(jiān)測,均為健康成年恒河猴;各實(shí)驗(yàn)用猴眼前段檢查結(jié)膜無充血水腫、角膜透明、前房深度正常、瞳孔圓,直徑3 mm、晶狀體透明,均達(dá)到正常眼要求。實(shí)驗(yàn)用猴飼養(yǎng)于該中心普通動(dòng)物房,分籠飼養(yǎng),室溫(21±5)℃,相對濕度(55±15)%,12 h明暗交替,全價(jià)營養(yǎng)顆粒飼養(yǎng),去離子水裝瓶飲用,每日添加水果。
1.2 HUVEC的制備 HUVEC細(xì)胞株用含體積分?jǐn)?shù)10%胎牛血清及體積分?jǐn)?shù)1%雙抗的1640培養(yǎng)液培養(yǎng)傳代至第三代,用1640液制備密度為 0.5×109~0.6×109L-1的細(xì)胞懸液備用。
6只恒河猴手術(shù)均于1 d內(nèi)完成,術(shù)后所有動(dòng)物均由中國醫(yī)學(xué)科學(xué)院醫(yī)學(xué)生物學(xué)研究所靈長類研究中心飼養(yǎng),術(shù)后每日用妥布霉素/地塞米松眼液滴術(shù)眼2次,每日復(fù)方托吡卡胺眼液滴術(shù)眼1次。術(shù)后一周加用環(huán)孢霉素A眼液滴術(shù)眼至術(shù)后1個(gè)月。
1.4 術(shù)后觀察各組角膜植片情況 術(shù)后取標(biāo)本做病理切片、CD34免疫組化及電鏡掃描,觀察房角結(jié)構(gòu)及HUVEC在角膜內(nèi)表面的形態(tài)。
2.1 HUVEC形態(tài)學(xué)觀察 HUVEC為貼壁生長的細(xì)胞,且傳代培養(yǎng)的生長速度較快,2 d就能鋪滿25 mL培養(yǎng)瓶底,細(xì)胞大致呈梭型,呈鋪路石樣貼壁生長(圖1A)。
2.2 通過離心沉淀法種植到去除后彈力層的恒河猴角膜內(nèi)表面上去的HUVEC形態(tài)學(xué)觀察 倒置顯微鏡下恒河猴CEC呈較為規(guī)律的單層六邊形結(jié)構(gòu)(圖1B)。去除中央后彈力層之后顯微鏡下角膜植片上未見殘留的CEC(圖1C)。制備HUVEC細(xì)胞懸液時(shí)需用胰蛋白酶將貼壁細(xì)胞消化下來,吹打后方能制成,因而原本呈梭形貼壁生長的HUVEC經(jīng)過短暫的2.5 g·L-1胰蛋白酶消化后,即開始疏散變圓。離心機(jī)驅(qū)動(dòng)時(shí),樣品液就隨離心管做勻速圓周運(yùn)動(dòng),于是就產(chǎn)生了一個(gè)向外的離心力。
因?yàn)楸緦?shí)驗(yàn)所用離心速度較低并且是漸進(jìn)加速,所以對移植細(xì)胞的形態(tài)不會有很大影響而且能使細(xì)胞較均勻的貼壁,于是懸液中移植上去的HUVEC呈類圓形而非貼壁生長時(shí)呈均勻梭形分布(圖1D),移植上去的HUVEC細(xì)胞數(shù)量約為3000 mm-2。
Figure 1 Morphology observation of HUVEC.A:Human vascular endothelial cells cultured and expanded to the third generation(×200);B:Rhesus monkey corneal endothelial cells showed single-layer hexagonal structure under inverted microscope(×40);C:No residual corneal endothelial cells on the inner surface of cornea after the central Descemet-membrane removed(×40);D:HUVEC on the inner surface of Rhesus monkey corneal graft by the centrifugation method(×40) HUVEC形態(tài)學(xué)觀察。A:培養(yǎng)擴(kuò)增至第三代的HUVEC(×200);B:倒置顯微鏡下恒河猴角膜內(nèi)皮細(xì)胞呈六邊形單層分布(×40);C:去除中央后彈力層之后的角膜植片,其上未見殘留的CEC(×40);D:通過離心沉淀法種植到恒河猴角膜內(nèi)表面的HUVEC(×40)
2.3 移植后角膜透明性和前房深度的觀察 術(shù)后3 d,實(shí)驗(yàn)組角膜植片透明度較好,前房可見,植片未見明顯水腫(圖2A);實(shí)驗(yàn)對照組角膜植片輕微水腫,前房可見(圖2B);空白對照組角膜植片透明度好,前房可見,植片未見明顯水腫(圖2C)。
術(shù)后14 d,實(shí)驗(yàn)組植片仍維持一定厚度和透明性,植片稍水腫,前房可見(圖2D);實(shí)驗(yàn)對照組植片開始水腫混濁(圖2E);空白對照組角膜植片透明度較好,前房可見,植片未見明顯水腫(圖2F)。
術(shù)后30 d,實(shí)驗(yàn)組植片較前稍水腫,但仍維持一定透明性,前房可見(圖2G);實(shí)驗(yàn)對照組植片明顯水腫混濁,前房深度隱約可見(圖2H);空白對照組角膜植片透明度較好,前房可見,植片未見明顯水腫(圖2I)。
術(shù)后60 d,實(shí)驗(yàn)組植片水腫較重,但仍維持一定透明性,前房可見(圖2J)。
實(shí)驗(yàn)對照組植片發(fā)生嚴(yán)重大泡性改變,前房深度淺(圖2K);空白對照組角膜植片透明度較好,前房可見,植片未見明顯水腫(圖2L)。
Figure 2 Photos of Rhesus monkey corneal graft each group at different time points after surgery.A:3 days after surgery in the experimental group;B:3 days after surgery in the experimental control group;C:3 days after surgery in the control group;D:14 days after surgery in the experimental group;E:14 days after surgery in the experimental control group;F:14 days after surgery in the control group;G:30 days after surgery in the experimental group;H:30 days after surgery in the experimental control group;I:30 days after surgery in the control group;J:60 days after surgery in the experimental group;K:60 days after surgery in the experimental control group;L:60 days after surgery in the control group 術(shù)后不同時(shí)間點(diǎn)各組恒河猴角膜植片大體圖片。A:實(shí)驗(yàn)組術(shù)后3 d;B:實(shí)驗(yàn)對照組術(shù)后3 d;C:空白對照組術(shù)后3 d;D:實(shí)驗(yàn)組術(shù)后14 d;E:實(shí)驗(yàn)對照組術(shù)后14 d;F:空白對照組術(shù)后14 d;G:實(shí)驗(yàn)組術(shù)后30 d;H:實(shí)驗(yàn)對照組術(shù)后30 d;I:空白對照組術(shù)后30 d;J:實(shí)驗(yàn)組術(shù)后60 d;K:實(shí)驗(yàn)對照組術(shù)后60 d;L:空白對照組術(shù)后60 d
2.4 角膜植片CD34免疫組化切片及HE染色切片 抗CD34單克隆抗體免疫組化染色顯示實(shí)驗(yàn)組有一層HUVEC在角膜內(nèi)表面生長,胞漿被染成棕黃色,與角膜基質(zhì)層融合,細(xì)胞基底處未見明顯后彈力層樣物質(zhì)(圖3A)。實(shí)驗(yàn)對照組缺乏后彈力層和CEC層,裸露角膜基質(zhì)角膜水腫(圖3B)??瞻讓φ战M抗CD34單克隆抗體免疫組化染色顯示一層CEC被覆于角膜后彈力層上,CEC胞漿未著染棕黃色,為正常角膜切片(圖3C)。
實(shí)驗(yàn)組角膜組織切片HE染色顯示一層HUVEC在角膜內(nèi)表面生長,與角膜基質(zhì)貼附良好,細(xì)胞基底面未見明顯后彈力層樣物質(zhì)(圖3D)。實(shí)驗(yàn)對照組未見任何細(xì)胞生長,裸露角膜基質(zhì),角膜水腫(圖3E)??瞻讓φ战M角膜組織切片HE染色顯示完整的CEC層,細(xì)胞基底為有明顯的深染的后彈力層(圖3F)。
2.5 恒河猴角膜植片以及小梁網(wǎng)區(qū)域術(shù)前術(shù)后掃描電鏡圖像 空白對照組保存完整的六邊形CEC層,細(xì)胞之間連接緊密(圖4A)。實(shí)驗(yàn)對照組角膜內(nèi)表面殘留膠原纖維樣物質(zhì)(圖4B)。實(shí)驗(yàn)組HUVEC種植后30 d,HUVEC疏松貼附于去除CEC層的恒河猴角膜內(nèi)表面,細(xì)胞胞體變大,開始向周圍伸展,細(xì)胞表面多個(gè)細(xì)絨毛狀白色突起,部分細(xì)胞間已相互接觸形成緊密連接(長箭頭),但仍然可見無細(xì)胞被覆的角膜基質(zhì)膠原纖維裸露區(qū)域(短箭頭),HUVEC周圍可見多個(gè)白細(xì)胞及少量紅細(xì)胞(燕尾箭頭)(圖4C)。HUVEC種植后60 d:種植上去的HUVEC形態(tài)已開始向成熟細(xì)胞分化,細(xì)胞之間連接呈片狀覆蓋于去除CEC層的恒河猴角膜內(nèi)表面。但HUVEC周圍可見大量白細(xì)胞(圖4D)。一些種植上去的VEC嵌頓于小梁網(wǎng)處,并可見多量白細(xì)胞及細(xì)胞碎片堵塞小梁網(wǎng)空隙(圖4E-圖4F)。
Figure 4 Scanning electron microscope images of Rhesus monkey corneal graft and trabecular meshwork before and after surgery;A:Normal Rhesus monkey cornea(×600);B:Corneal stromal collagen fibers exposed after removing the corneal endothelial cell layer(×3000);C:30 days after HUVEC implant in the experimental group(×900);D:60 days after HUVEC implant in the experimental group(×900);E:Ttrabecular meshwork image after HUVEC implant in the experimental group(×150);F:Ttrabecular meshwork image after HUVEC implant in the experimental group(×1000) 恒河猴角膜植片以及小梁網(wǎng)區(qū)域術(shù)前術(shù)后掃描電鏡圖像。A:空白對照組恒河猴CEC圖像(×600);B:實(shí)驗(yàn)對照組去除CEC層之后裸露角膜膠原基質(zhì)纖維(×3000);C:實(shí)驗(yàn)組HUVEC種植到角膜內(nèi)表面后30 d,部分細(xì)胞間已相互接觸形成緊密連接(長箭頭),但仍然可見無細(xì)胞被覆的角膜基質(zhì)膠原纖維裸露區(qū)域(短箭頭),HUVEC周圍可見多個(gè)白細(xì)胞及少量紅細(xì)胞(燕尾箭頭)(×900);D:實(shí)驗(yàn)組HUVEC種植到角膜內(nèi)表面后60 d(×900);E:實(shí)驗(yàn)組HUVEC種植到角膜內(nèi)表面后的小梁網(wǎng)(×150);F:實(shí)驗(yàn)組HUVEC種植到角膜內(nèi)表面后的小梁網(wǎng)(×1000)
國內(nèi)外目前對于角膜內(nèi)皮功能失代償治療的研究主要集中于以下方面:(1)利用異體角膜基質(zhì)[1]、羊膜[2-3]和其他材料[1,4-5]為體外培養(yǎng)的CEC的載體進(jìn)行內(nèi)皮細(xì)胞移植;(2)各種類型的后彈力層CEC移植術(shù)[6-9];(3)體外培養(yǎng) “永生化CEC”的研究。以上研究均獲得了一些新的發(fā)現(xiàn),但仍然難以在臨床推廣。為此我們力求尋找一種能再生且具有CEC樣功能的細(xì)胞來替代受損的CEC。VEC與CEC具有結(jié)構(gòu)和功能上的諸多相似性[10]:兩種細(xì)胞均為單層細(xì)胞分布;兩種細(xì)胞膜上都具有共同維持細(xì)胞內(nèi)、外水平衡功能的鈉離子通道和水通道蛋白1、4型;房水屬于血液的超濾液,其化學(xué)成分與血漿基本相似。兩種細(xì)胞的不同之處:靈長類動(dòng)物(包括人類)CEC在成年后不再進(jìn)行有絲分裂;VEC再生性強(qiáng),受損后可增殖修復(fù)而形成完整的內(nèi)皮屏障;VEC能自分泌產(chǎn)生血管內(nèi)皮生長因子等細(xì)胞因子。Gospodarowicz等[11]首次提出了用VEC替代CEC的想法,通過動(dòng)物實(shí)驗(yàn)取得了一定的成果,但自體VEC的取材和培養(yǎng)都較為困難。
實(shí)驗(yàn)中我們選擇的HUVEC來源廣泛,免疫原性低,并且通過病理切片和掃描電鏡觀察HUVEC能被移植到去除后彈力層的恒河猴角膜內(nèi)表面,存活一定時(shí)期,維持了一定程度角膜的透明性和厚度,這將使HUVEC有可能成為用于替代人CEC功能的可供選擇的細(xì)胞之一。
本實(shí)驗(yàn)中,實(shí)驗(yàn)對照組術(shù)后60 d角膜植片呈現(xiàn)典型角膜大泡性改變,病理切片和掃描電鏡也證實(shí)該組恒河猴CEC受損后,周邊健存的CEC無法分裂增殖,與人類相似[12]。隨著時(shí)間的推移,實(shí)驗(yàn)對照組角膜植片水腫和混濁情況隨時(shí)間加重最終形成典型的大泡性改變;而實(shí)驗(yàn)組術(shù)后角膜植片雖然也有發(fā)生水腫混濁的趨勢,但速度明顯慢于實(shí)驗(yàn)對照組,證明移植上去的HUVEC在一定時(shí)間內(nèi)起到了阻隔房水進(jìn)入角膜實(shí)質(zhì)的屏障作用,但由于移植上去的HUVEC從貼壁到胞體逐漸變大向周圍伸展,最終彼此緊密連接成單層細(xì)胞還需要一段時(shí)間,所以術(shù)后角膜植片仍然有發(fā)生水腫混濁的可能。
本實(shí)驗(yàn)中我們發(fā)現(xiàn),HUVEC種植到了去除內(nèi)皮層的角膜植片上后與角膜基質(zhì)融合,其下缺乏均勻顯色的后彈力層樣物質(zhì)。這可能是因?yàn)椋赫G闆r下,角膜后彈力層損傷后由CEC分泌的蛋白重新組成新的后彈力膜維持角膜的完整性[13]。然而,血管內(nèi)膜損傷后只能靠血管基底膜中的平滑肌細(xì)胞遷移及其分泌的纖維蛋白來完成內(nèi)膜的修復(fù)功能,平滑肌細(xì)胞的遷移和VEC的再生需要健康VEC分泌的一些細(xì)胞因子參與[14],這說明血管內(nèi)膜的形成是血管平滑肌細(xì)胞和VEC相互作用的結(jié)果。實(shí)驗(yàn)中掃描電鏡未見HUVEC多層生長或形成管狀結(jié)構(gòu)??赡艿脑蛴校?1)細(xì)胞生長的接觸抑制作用[15-18]。正常的體內(nèi)條件下,內(nèi)皮細(xì)胞可能更接近于這種狀態(tài)。文獻(xiàn)報(bào)道[19-20],小鼠成纖維細(xì)胞系NIH3T3的CD155分子表達(dá)下調(diào)與其細(xì)胞接觸抑制有關(guān)。(2)植片表面平坦面積較大。(3)離心沉淀法的應(yīng)用。離心沉淀法移植HUVEC最初少量細(xì)胞會堆積于植片內(nèi)表面,但堆積的HUVEC會因無法貼壁生長以及房水的流動(dòng)而脫落。(4)房水營養(yǎng)成分。房水中蛋白質(zhì)、氨基酸和葡萄糖的含量低于血漿,使位于房水環(huán)境中的HUVEC不會出現(xiàn)過度增殖的情況。
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date:Jun 2,2014
Accepted date:Jul 16,2014Foundation item:Yunnan Provincial Science and Technology Department - Kunming Medical College Joint Project(No:2013FB109)From theDepartmentofOphthalmology,theFourthAffiliatedHospitalofKunmingMedicalCollege(ZHANG Wen-Jia,HU Zhu-Lin,ZHU Qin,WEI Chun-Ling,LIU Hai,YANG Zhong-Kun),Kunming650021,YunnanProvince,China;ChinesePekingUnionMedicalBiologicalInstution,ChineseAcademyofMedicalSciences(SUN Xiao-Mei,DAI Jie-Jie),Kunming650000,YunnanProvince,China
Responsible author:HU Zhu-Lin,E-mail:1021862477@qq.com
Microstructure observation of human vascular endothelial cells transplantation in autograft to replace monkey corneal endothelial cells
ZHANG Wen-Jia,HU Zhu-Lin,ZHU Qin,WEI Chun-Ling,SUN Xiao-Mei,DAI Jie-Jie,LIU Hai,YANG Zhong-Kun
vascular endothelium cell;corneal endothelium cell;rhesus monkey
Objective Using the Descemet’s membrane-removed rhesus autologous corneal as the cell carrier and transplant the cultured human umbilical vein endothelial cells(HUVEC) to the inner surface of the cornea,to observe the function of HUVEC after alternative rhesus monkey corneal endothelial cell and the growth of the HUVEC in the rhesus monkey eye corneal surface.Methods The experimented monkeys were divided into 3 groups:experimental group(3 cases),experimental control group(2 cases) and blank control group(1 case).In experimental group,cultured HUVEC were transplanted onto rhesus monkey posterior corneal surface without corneal endothelium;In experimental control group,the detached corneal Descemet membrane of rhesus monkey fixed in suit without cultured HUVEC transplantation;In blank control group,a simple penetrativity corneal transplantation without destroy the descemet membrane performed.The transparent of implants in each group was observed after corneal transplantation.Histopathology of cornea grafts,immunohistochemistry and scanning electron microscope were performed at 30 days and 60 days postoperatively in order to observe the appearance of HUVEC onto the monkey posterior corneal surface and the structure of anterior chamber angle.Results The corneal implants of experimental group kept transparency and thickness in some extent while the experimental control group showed severity corneal edema and bullae.Histopathology of corneal grafts showed that a cells layer with CD34 staining positive reaction growth on posterior corneal surface of corneal button in the experimental group,which indicated that the layer of cells were HUVEC,no cell and material like membrane could be seen on that of the experimental control group;A layer of corneal endothelial cells and Descemet’s membrane were visible on that of the blank control group.Scanning electron microscope showed that a layer of HUVEC were growing on the posterior surface of cornea button with plenty of leucocytes and small amounts of cell debris could be found to block up the trabecula meshwork,collagen fibers remained on the posterior surface of cornea button of the experimental control group with no cell grown;The complete corneal endothelial cells layer with six-fringe shape could be found in the blank control group.Conclusion HUVEC can survive and enduce the barrier function at the posterior surface of rhesus monkey cornea without corneal endothelial cells,and keep the cornea button transparency and normal thickness in some extent,but severe rejection will happen.
張文佳,胡竹林,朱勤,韋春玲,孫曉梅,代解杰,等.人臍靜脈血管內(nèi)皮細(xì)胞在體移植替代猴角膜內(nèi)皮細(xì)胞的形態(tài)學(xué)分析[J].眼科新進(jìn)展,2014,34(11):1020-1024.
10.13389/j.cnki.rao.2014.0283
張文佳,女,1982年1月出生,云南省昆明市人,碩士,研究方向?yàn)榻悄げ?、白?nèi)障。聯(lián)系電話:13577090718;E-mail:1021862477@qq.com
About ZHANG Wen-Jia:Female,born in January 1982.Master degree.Tel:13577090718;E-mail:10218624 77@qq.com
2014-06-02
2013年云南省科技廳-昆明醫(yī)科大學(xué)應(yīng)用基礎(chǔ)研究聯(lián)合專項(xiàng)(編號:2013FB109)
650021 云南省昆明市,昆明醫(yī)科大學(xué)第四附屬醫(yī)院眼科(張文佳,胡竹林,朱勤,韋春玲,劉海,楊忠昆);650000 云南省昆明市,中國醫(yī)學(xué)科學(xué)院中國協(xié)和醫(yī)科大學(xué)醫(yī)學(xué)生物學(xué)研究所(孫曉梅,代解杰)
胡竹林,E-mail:102186 2477@qq.com
修回日期:2014-07-16
本文編輯:董建軍
[Rec Adv Ophthalmol,2014,34(11):1020-1024]