Proliferative response of lymphocyte to pokeweed mitogen depends on the concentration of endogenous cortisol in the early post-traumatic period in patients with penetrating eye injury.

The intensity of lymphocyte proliferation in response to pokeweed mitogen depends on cortisol level in the peripheral blood in the early post-traumatic period of penetrating eye injury. Lymphocyte proliferation in 72- and 96-h cultures from patients with high levels of endogenous hormone was suppressed. In 120-h cultures, the intensity of proliferation remains unchanged. Lymphocyte blast transformation was increased in 120-h cultures from patients with normal cortisol concentration and remained unchanged in case of low cortisol level.

[Hymenoptera stings in eyeball--clinical symptoms, patomechanism and treatment]. / Uzadlenia owadów blonkoskrzydlych w galek socznq - objawy kliniczne, ich patomechanizm i leczenie.

Eyeball is a rare stings location additionally with very special immunology response, with no systemic anaphylactic reactions. The ACAID (Anterior Chamber Associated Immune Deviation) phenomenon causes a special immunology privilege of the eyeball, which prevents late immunological answer reaction and destruction processes of the anterior part of the eye. In case that sting penetrates the eyeball local allergic reaction can appear despite ACAID phenomenon. Adequate treatment is necessary for those patients. It can lead to permanent visual acuity deterioration.

Confocal microscopic evidence of increased Langerhans cell activity after corneal metal foreign body removal.

PURPOSE: The purpose of the study was to examine the corneal inflammatory reaction and Langerhans cells with confocal microscopy after metal foreign body removal. METHODS: Corneal metal foreign body was removed from 9 eyes of 9 consecutive patients 12.1+/-13.6 (4 to 72) hours after superficial angle grinder injury. Both eyes were examined with the Heidelberg Retina Tomograph II (HRT II) Rostock Cornea Module. Morphology and density of epithelium, nerves, metal deposits, keratocytes, endothelium, and Langerhans cells were compared to the uninjured fellow eyes (controls). RESULTS: Irregularity and partially missing superficial epithelium was found in all cases. Around the area of injury prolonged basal and wing epithelial cells were found in all eyes. The basal epithelium density is lower than in the control eye (p=0.043). Density of Langerhans cells (68.1+/-24.2/mm2) was increased in the epithelium, compared to controls (35.2+/-21.8/mm2, p=0.012). Keratocyte and endothelium densities were not different from that of controls. Some keratocytes showed signs of activation and the inhomogeneous background reflectivity revealed extracellular matrix alterations. Inflammatory reaction was observed up to260 micronm depth. The metal foreign body particles had high reflectivity and irregular edge. CONCLUSIONS: In vivo confocal microscopy provided additional information to biomicroscopic signs such as epithelial damage and inflammation. It showed the effects of metal foreign bodies in the cornea: nerve damage and Langerhans cell density increase. Langerhans cells seem to play an important role in the inflammatory response after corneal foreign body injuries.

[Sympathetic ophthalmia--clinical case]. / Oftalmia simpatica --caz clinic.

This paper presents a case of Sympathetic ophthalmia following a penetrating ocular injury produced 30 days ago, of a patient who postponed the presentation to the ophthalmologist.

Interacting influences of pregnancy and corneal injury on rabbit lacrimal gland immunoarchitecture and function.

PURPOSE: Previous reports indicated that pregnancy and corneal injury (CI) trigger alterations of lacrimal gland (LG) growth factor expression and redistributions of lymphocytes from periductal foci to acini. The purpose of this study was to test our hypothesis that pregnancy would exacerbate the changes induced by CI. METHODS: Corneas were injured with scalpel blades, and, 2 weeks later, LGs were collected for immunocytochemistry and Western blot analysis. Lacrimal fluid was collected under basal- and pilocarpine-stimulated conditions for protein determination and Western blot analyses. RESULTS: There were significant increases of immunoreactivity for prolactin, TGF-beta1, and EGF in duct cells during pregnancy and after CI, most prominent in pregnant animals with CI. Pregnancy decreased baseline lacrimal fluid secretion, whereas CI did not have a noticeable effect; pregnancy and CI combined resulted in increased fluid production. Pregnancy and CI each increased pilocarpine-induced lacrimal fluid production, whereas protein concentrations were decreased. Prolactin, TGF-beta1, and EGF were detected in LG by Western blot analysis but were minimally detectable in lacrimal fluid. RTLA+ and CD18+ cells were redistributed from periductal to interacinar sites during pregnancy and after CI, most prominent in pregnant animals with CI. CONCLUSIONS: Like pregnancy, CI is associated with redistribution of immune cells from periductal to interacinar sites and enhanced immunoreactivity of prolactin, TGF-beta1, and EGF in ductal cells. Although baseline lacrimal fluid secretion varied, the glands of all three experimental groups produced significant amounts of fluid in response to pilocarpine, but protein concentrations were decreased.

CD4+ T cell/CD8+ T cell ratio in the anterior chamber of the eye after penetrating injury and its comparison with normal aqueous samples.

We have recently reported that significantly more CD8+ T-cell activity is present in the aqueous humor compared to peripheral blood. The aim of the current study is to investigate the effect of the ocular trauma on the number of the T lymphocyte subsets in the aqueous humor. CD4+/CD8+ T-cell ratios in the aqueous and blood samples of 12 patients who suffered from traumatic iridocyclitis because of a corneal perforation were compared to those of patients with senile cataracts. We found a relatively higher CD4+/CD8+ cell ratio in the aqueous samples of traumatized patients than cataractous patients. Meanwhile, no difference was present between the aqueous and blood samples of the traumatized patients with respect to the above-mentioned ratio. We suggest that one of the most important factors in maintaining a lower CD4+/CD8+ cell ratio in normal aqueous humor compared to peripheral blood is an intact blood-aqueous barrier. Blood-aqueous barrier may play a participating role in the pathogenesis of immunosuppressive properties of the anterior chamber of the eye by establishing higher CD8+ T-cell activity in the aqueous humor relative to the peripheral blood.

[Proliferative vitreoretinopathy. Activation of the complement system]. / Die proliferative Vitreoretinopathie. Aktivierung des Komplementsystems.

The complement system is a principal constituent of humoral immune reactions. Because of the multitude of biological effects related to complement activation, we analyzed its potential pathophysiological importance in the development of proliferative vitreoretinopathy (PVR). Vitreous aspirates from patients with idiopathic PVR (n = 7) and traumatic PVR (n = 11) were examined for total vitreal protein, complement components C3, C3d, and C1q-fixed immunoglobulins using enzyme-linked immunosorbent assay (ELISA), SDS-Page and Western blotting. Total vitreal protein and C3 components were significantly elevated both in traumatic and idiopathic PVR. Elevated levels of C3d titers in both PVR forms reflect an activation of the complement system. C1q-fixed IgG suggests complement activation via the classic pathway as a result of a humoral antibody-dependent immune reaction.

[A study on RBC immunofunction in experimental traumatic uveitis].

Examination of the RBC immunofunction in rabbit experimental traumatic uveitis with Guo's method of complement-labelled yeast revealed that the percentage of RBC C3b receptor rosette and the activity of red cell immune adherence (RCIA) enhancing factor in sera were markedly lower, while the percentage of RBC surface immune complex rosette, the activity of the RCIA-inhibiting factor and the CIC in sera were higher than those in the normal controls, indicating that the lowered RBC immunofunction was involved in pathogenesis of the experimental traumatic uveitis.

[The change of immunoglobulin in patients with eyeball perforation at high altitude].

OBJECTIVE: To explore the change of tear immune function on eyeballs with perforating injury at high altitude. METHODS: In 51 patients (53 eyes) with eyeball perforating injury at high altitude (sea level 3658 m), by using single agar immune diffusion test, IgG, IgA, IgM, C(3) and C(4) values of tears were separately measured before and after clinical cure. RESULTS: The Ig values of tears increased universally. The IgA value increased especially in the 7th day. The IgG and IgM value in the serum increased in the 3rd day after injury (P < 0.05), and the IgG, IgA and IgM of tears increased especially on the 7th day (P < 0.01). The C(3) and C(4) value of tears did not change significantly (P < 0.05). CONCLUSIONS: The change of Ig value is a useful detective means to evaluate the treatment effect.

[Immunological reactions in pathogenesis of posttraumatic uveitis and eyeball subatrophy]. / Immunologicheskie reaktsii v patogeneze posttravmaticheskogo uveita i subatrofii glaznogo iabloka.

Clinical and morphological examinations of 30 eyes enucleated for relapses of traumatic uveitis and subatrophy caused by grave penetrating wounds involving a complete loss of visual function were carried out and 12 patients were tested for sensitization to tissue antigens by the leukocyte migration inhibition test. Morphological examination revealed cellular reaction in eye membranes, indicating an autoimmune process developing in response to release of the antigenic tissue substances of the eye into the bloodflow and reactive flow of immunocompetent cells towards ocular tissues because of injury to the blood-eye barrier. Detection of sensitization to tissue antigen in the patients confirms this viewpoint. The authors compare the revealed inflammatory process in the injured eye with the graft rejection reaction and find them similar.

[Course of acute traumatic uveitis and rate of secondary immunological insufficiency detection at pre-laboratory level]. / Osobennosti techeniia ostrogo travmaticheskogo uveita i vyiavliaemost' vtorichnoi immunologicheskoi nedostatochnosti na dolaboratornom urovne.

Course of acute traumatic uveitis was evaluated in 146 patients with penetrating wounds of different severity in scores starting from the first days after the injury was inflicted and after operations performed in early terms after the injury. The inflammatory process normalized by weeks 2-3 in a favorable course, while in severe injuries and early reoperations and in wounds of the fourth degree of severity posttraumatic uveitis persisted during weeks 3-4, and 35.2% patients developed chronic posttraumatic uveitis. Clinical signs of immunological insufficiency, presenting mainly as the infectious syndrome (28%), were detected in 35.6% patients with penetrating injuries on the basis of case history analysis by means of a universal diagnostic chart and clinical findings. Penetrating wounds of the third and fourth degree of severity, reoperations during early terms after primary surgical treatment, chronic inflammatory diseases (mainly of the ENT and bronchopulmonary system, indicating secondary immunodeficiency, which necessitate prescription of immunocorrectors starting from the first days after the injury) are factors of risk of protracted or chronic course of posttraumatic uveitis.

[Functional and morphological features of vitreoretinal proliferation after penetrating wounds of eye complicated by hemophthalmos (immunohistochemical and electron microscopy study)]. / Funktsional'no-morfologicheskie osobennosti vitreoretinal'noi proliferatsii posle pronikaiushchikh ranenii glaza, oslozhnennykh gemoftal'mom (immunogistologicheskoe i élektronno-mikroskopicheskoe issledovanie).

Comprehensive (optic, electron, and fluorescent microscopy) morphological analysis of vitreous fragments removed in vitrectomy after penetrating wounds of the eye complicated by hemophthalmia showed that blood and damaged cells of pigment-free ciliary epithelium and the glia play an important role in the development of proliferative processes in the ophthalmic cavity. Immunohistochemical studies revealed active expression of immunoglobulins A and G and of HLA-DR antigen on immunocompetent cells and abnormal expression of HLA-DR in pigment-free ciliary epithelium and the glia, confirming the autoimmune origin of inflammatory disorders.

Effects of myelopeptides on immune response and morphometrical manifestations of inflammation in experimental penetrating wound of the eye.

Myelopid and MP-1 myelopeptide increase the count of antibody-producing cells, reduced under the effect of injury and standard therapy, and do not modify the suppression of delayed hypersensitivity. Injections of myelopid and MP-3 together with standard drugs optimized the traumatic inflammation processes.

Anti-receptor antibodies inhibit Pseudomonas aeruginosa binding to the cornea and prevent corneal perforation.

A polyclonal antibody (pAb) against gangliotetraosylceramide (asialo GM1), a glycolipid to which bacterial pili and LPS bind, and a mAb against a 66 kDa pilus-binding protein purified from adult mouse corneal epithelium were used to determine if antibodies against host receptors for bacterial adhesins could inhibit bacterial binding to wounded corneal epithelium and protect ocularly challenged mice from corneal perforation when topically applied. Bacteria were mixed with anti-66 kDa mAb, a mixture of anti-asialo GM1 pAb and anti-66 kDa mAb, an irrelevant control mAb (anti-human histocompatibility Ag HLA-DR5) or PBS prior to application to scarified corneas in organ culture. The combination of the two antibodies or the anti-66 kDa mAb alone was effective in reducing bacterial adherence compared with either PBS or the antibody control. To determine if these antibodies were protective in vivo, corneas of C57BL/6J mice were scarified and inoculated with Pseudomonas aeruginosa. Eyes were treated topically with anti-asialo GM1 pAb, anti-66 kDa mAb, a mixture of the two or control mouse serum. More serum-treated corneas perforated compared to corneas from any other group (P < or = 0.005) by 30 days postinfection. Treatment with a combination of the two antibodies resulted in significantly less corneal pathology 30 days p.i. when compared to any other treatment (P < or = 0.005). These data provide evidence that antibodies against host corneal receptors significantly inhibit bacterial binding in vitro and when applied topically in vivo, lessen the severity of ocular disease characteristic of P. aeruginosa keratitis.

[Sympathetic ophthalmia 50 years after penetrating injury. A case report]. / Sympathische Ophthalmie 50 Jahre nach perforierender Verletzung. Eine Kasuistik.

BACKGROUND: Sympathetic ophthalmia is a rare form of autoimmune uveitis and manifests in 90% of cases within the first year after penetrating injuries or surgical interventions. PATIENTS AND METHODS: In the present case the sympathetic ophthalmia started 50 years after a penetrating injury by a shell splinter. The injured eye was amaurotic and phthitic and the sympathizing eye showed an anterior uveitis. After an initial treatment with local and systemic corticosteroids the uveitis improved. The clinical diagnosis of sympathetic ophthalmia was made after a second inflammation course with substantial visual loss and subtotal chorioidal detachment. After enucleation of the exciting eye the diagnosis was confirmed by histological examination. An immunosuppressive therapy including azathioprine and cyclosporine became necessary to control the uveitis. RESULTS: After enucleation the corticosteroid treatment was not sufficient. Additional therapy with azathioprine resulted in a recovery of the symptoms but had to be stopped because of adverse reactions. The alternative therapy by means of cyclosporine was tolerated well, but dose reduction was difficult because of recurrences. After a 30 month lasting cyclosporine therapy the patient shows stabile results since 6 months with visual acuity of 20/30. CONCLUSIONS: The present case report demonstrates that a delayed onset of sympathetic ophthalmia 50 years after initial trauma may occur but can be controlled by an immediate, high dose immunotherapy.

Perioperative analysis of vitreous cell components by immunoimpression cytology.

BACKGROUND: Perioperative analysis and classification of vitreous cell components needs a quick method sufficient to prepare both single cells and cellular membranes. METHODS: In an attempt to clarify the usefulness of immunoimpression cytology we examined 82 eyes with proliferative vitreoretinopathy, proliferative diabetic retinopathy, perforating injuries and contusions. RESULTS: With this method it is possible to perioperatively obtain cells from surfaces of vitreous membranes as well as single cells in suspension. After staining, various cell types could be differentiated morphologically and on the basis of antibody response to cell markers. We found single cells reacting with the antibodies 27E10 (4 positive of 14 tested), vimentin (2/12), RM 3/1 (2/15), LCA (1/ 11) and, particularly, with antiproliferating cell nuclear antigen (9/18). CONCLUSION: With immunoimpression cytology it is possible to determine cell surface markers rapidly and accurately from specimens obtained at the time of vitrectomy. The clinical utility of this test will be ascertained by future studies.