巨噬细胞在真菌性角膜溃疡中的作用  

Role of macrophages in fungal keratitis

作　　者：罗艳婷 杨珺铭 罗雅琪 吴瞬亮 彭梓轩 何宏[2] 钟兴武[2] Luo Yanting;Yang Junming;Luo Yaqi;Wu Shunliang;Peng Zixuan;He Hong;Zhong Xingwu(Department of Ophthalmology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,Hainan Province,China;Hainan Eye Hospital,Zhongshan Ophthalmic Center,Sun Yat-sen University/Hainan Eye Hospital/Hainan Provincial Key Laboratory of Ophthalmology,Haikou 570311,Hainan Province,China)

机构地区：[1]海南医科大学第一附属医院眼科,海南省海口市570102 [2]中山大学中山眼科中心海南眼科医院、海南省眼科医院、海南省眼科学重点实验室,海南省海口市570311

出　　处：《国际眼科杂志》2024年第10期1582-1587,共6页International Eye Science

基　　金：海南省卫生健康科技创新联合项目(No.WSJK2024MS128);海南省临床医学研究中心项目(No.LCYX202406);海南省重点研发项目(No.ZDYF2022SHFZ326)。

摘　　要：真菌性角膜溃疡是严重的致盲性眼病。真菌感染的发生主要取决于真菌毒力和宿主免疫防御因素之间的相互作用。角膜被认为是免疫特权器官,驻留的巨噬细胞是主要的免疫细胞,其极化响应微环境表现出的异质性。感染早期,巨噬细胞向M1极化,促进炎症发生,利于真菌清除但产生细胞风暴加重免疫损伤;感染后期,巨噬细胞向M2极化,可抑制炎症反应、促进组织修复但可能产生免疫抑制甚至免疫逃逸,不利于病原清除。促炎反应与抗炎反应之间的平衡是保持角膜功能完整性的关键。目前抗真菌药物治疗有限,因此除了抗真菌治疗外,寻找一种针对免疫反应引发的炎症反应的治疗靶点尤为重要。文章综述了真菌性角膜溃疡中巨噬细胞亚群的表型特征和功能,需要更深入的研究来探索巨噬细胞极化的具体机制及其对真菌性角膜溃疡的影响,基于巨噬细胞的表型和功能对巨噬细胞分化进行靶向调节可能是未来治疗和管理真菌性角膜溃疡的有效方法。Fungal keratitis is a serious blinding eye disease.The development of fungal infections depends primarily on the interaction of fungal virulence with host immune defense factors.The cornea is considered an immune-privileged organ,and resident macrophages are the main immune cells that respond to the heterogeneity exhibited by the microenvironment with their polarization.In the early stage of infection,macrophages polarize towards M1,which promotes inflammation and facilitates fungal clearance but produces a cellular storm that exacerbates immune damage;in the late stage of infection,macrophages polarize towards M2,which suppresses the inflammatory response and facilitates tissue repair,but may be immunosuppressed or even immune escape to the detriment of pathogen clearance.The balance between pro-inflammatory and anti-inflammatory responses is key to maintaining the functional integrity of the cornea.Current antifungal drug therapy is limited,so it is particularly important to find a therapeutic target for the inflammatory response triggered by the immune response in addition to antifungal therapy.In this review,the functional and phenotypic characterization of macrophage subsets associated with fungal keratitis was reviewed,more in-depth research is needed to explore the specific mechanisms by which macrophage polarization and their impact on fungal keratitis.Targeted regulation of macrophage differentiation based on their phenotype and function could be an effective approach to treat and manage fungal keratitis in the future.

关 键 词：巨噬细胞 极化 M1/M2 真菌性角膜溃疡 免疫 中性粒细胞 

分 类 号：R772.21[医药卫生—眼科]