苯并卟啉衍生物介导的光动力学疗法抑制兔眼滤过术后纤维化的研究  

Benzoporphyrin derivative induced photodynamic modulation of wound healing in rabbit model of filtration surgery

作　　者：陈慧怡[1] 葛坚[1] 金陈进[1] 刘海泉[1] 黄圣松[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《眼科研究》2006年第3期272-276,共5页Chinese Ophthalmic Research

基　　金：广东省卫生厅基金(B1999064;A2003229);广东省普通高校自然科学研究项目(042001)资助

摘　　要：目的探讨新型光敏剂苯并卟啉衍生物(BPD)介导的光动力疗法(PDT)抑制兔滤过术后术区纤维化的效果。方法制作新西兰大白兔滤过手术模型,PDT组术前3 h术区结膜下注射BPD 2.5μg,术后滤过区局部进行半导体激光照射;同时设单纯手术组、丝裂霉素C(MMC)组、BPD对照组和激光对照组。术后观察滤过泡形态、眼压及并发症情况,病理组织切片及电镜检查评价术区纤维化程度。结果PDT组和MMC组滤过泡存留时间明显长于单纯手术组、激光对照组和BPD对照组。单纯手术组术后3 d内眼压下降,术后1周恢复至术前水平,PDT组和MMC组在术后4周内均可维持比术前低的、稳定的眼压水平。与PDT组相比,MMC组的并发症更为严重。组织切片显示PDT组能明显抑制兔滤过区结膜下纤维增生,电镜检查提示术区成纤维细胞可能发生早期凋亡改变,胶原纤维数量明显减少。结论PDT在大白兔眼滤过术模型上可获得与MMC相近的抗纤维化效果,但并发症少,其可能的作用机制是抑制胶原纤维的合成。PDT有望成为调控青光眼术区纤维化的一种较为有效的方法。Objective Previous study showed the combination of benzoporphyrin derivative（BPD） and laser irradiation can inhibit proliferation of fibroblasts in vivo. This paper was to evaluate the safety and efficacy of BPD-induced photodynamic therapy （PDT） for fibrosis modulation in rabbit model of filtration surgery compared with mytomycin C. Methods Thirty-five New Zealand white rabbits （35 eyes ） were used to establish filtration surgery model by sclerostomy. Model rabbits received the combination of preoperative subconjunctival injection of 2. 5 μg BPD with postoperative laser irradiation in the filtration area in the PDT group. The filtration area of surgery was exposed to 689 nm of laser with the energy of 48 J/cm^2 and irradiation diameter of 7.5 mm after surgery in the laser group. 0. 25 mg/ml of MMC was used for the MMC group, and only 2. 5 μg of BPD was suhconjunctivally injected for the BPD group. The survival of filtration hlehs and intraocular pressure （IOP） were observed at different time points after surgery followed by histological and transmission electron microscopy （TEM） examination. Results The survival time of functional filtration blebs was 3 - 4 weeks in PDT group, and that in MMC group was 4 - 5 weeks. In contrast, the filtration bleb could only survive for 1 week in simple surgery group and laser irradiation group, and that in the BPD group was about 2 weeks. The postoperative IOP was decreased within 3 days but increased rapidly to a preoperative level after 7 days in simple surgery group. However,in the MMC and PDT groups,the IOP remained at a lower level for 4 weeks. MMC could cause the defect of conjunctival epithelia, infiltration of inflammatory cells and even endophthalmitis, while PDT only caused transient chemosis. The histological sections and TEM showed a signs of early apoptosis of fibroblasts in PDT group. Conclusion PDT achieves a similar result in filtration bleb survival and IOP control to MMC following sclerostomy in rabbits possibly through antifibrotic effec

关 键 词：苯并卟啉衍生物 光动力效应 成纤维细胞 

分 类 号：R779.6[医药卫生—眼科]