익상편 발생기전에서 말초혈액의 내피전구세포 및 혈관신생인자의 관여

목적 : 말초혈액의 내피전구세포 및 혈관신생인자가 익상편 발생기전에 관여하는 지 여부 및 그 가능한 기전을 알아보고자 하였다.<BR> 대상과 방법 : 익상편 환자와 대조군을 대상으로 vascular endothelial growth factor, stem cell factor, substance-P의 눈물 및 혈중 농도를 ELISA (Enzyme-linked immunosorbent assay)를 이용하여 측정하고, 말초혈액내 CD34양성 단핵세포와 c-kit양성 단핵세포를 유세포분석기로 측정하였다. 익상편 초기 환자들을 대상으로 전안부형광혈관조영술을 시행하였으며, 수술로 제거한 익상편 조직에서 면역형광염색을 이용하여 내피전구세포의 발현을 확인하였다.<BR> 결과 : 전얀부형광혈관조영술에서 초기 익상편 환자의 구결막에서 형광충만의 지연을 관찰하였다. 익상편군에서 말초혈액내 CD34양성 단핵세포와 c-kit양성 단핵세포의 수가 대조군에 비해 의미있게 증가되었으며(p<0.05), 눈물과 혈장내 VEGF, SCF, SP의 농도도 증가되었다(p＜0.05). 익상편 조직에서 CD34, c-kit, VEGFR-1, VEGFR-2의 발현을 관찰하였다.<BR> 결론 : 전안부의 허혈과 이에 따른 혈관신생인자와 말초혈액의 내피전구세포의 증가가 익상편 발생에 관여하는 것으로 생각된다.〈한안지 47(9):1472-1480, 2006〉

Purpose: We investigated whether endothelial progenitor cells (EPCs) and vasculogenic factors are involved in the pathogenesis of pterygium and the mechanism underlying the selective recruitment of EPCs during this process.<BR> Methods: We studied 13 normal controls and 28 pterygium patients [primary (n=15), recurrent (n=13)]. Substance-P, vascular endothelial growth factor (VEGF), and stem cell factor (SCF) were measured in plasma and tears using ELISA, and circulating CD34+ and c-kit+ mononuclear cells (MNCs) by flow cytometry. Anterior segment fluorescein angiography (FAG) was performed to evaluate hypoxic conditions in the early stage of pterygium. Surgically removed pterygial tissues were analyzed immunohistochemically using the progenitor cell markers, CD34, c-kit, VEGFR-1 and VEGFR-2.<BR> Results: Anterior segment FAG findings showed an increase in non-perfusion areas and attenuated vessels in the nasal limbus during early stage pterygium. Circulating CD34+ MNCs and c-kit+ MNCs were increased in pterygium groups compared with normal controls. Systemic and local cytokines including SP, VEGF and SCF in pterygium groups were also elevated and showed positive correlations with CD34+ and c-kit+ MNC numbers. Immunohistochemical analysis of pterygium showed strong progenitor cell marker immunoreactivities.<BR> Conclusions: EPCs might be involved in pterygium development, and ocular hypoxia triggers this neovascualrization by recruiting EPCs derived from the bone marrow via the production of systemic and local cytokines. J Korean Ophthalmol Soc 47(9):1472-1480, 2006