[关键词]
[摘要]
角膜神经在维持角膜的健康和功能方面发挥关键作用,病毒性角膜炎等疾病可致其损伤。近年来研究发现单侧角膜病变不仅影响患侧的角膜神经,对侧眼的神经也会受累; 此外,除了负责角膜知觉的感觉神经发生改变,病毒性角膜炎还可以影响交感神经。但临床除了共聚焦显微镜和角膜知觉外,尚缺乏评估角膜神经损伤程度及预后的有效指标。角膜神经通过释放神经肽发挥多种作用,其中P物质作为首个局部应用于临床的神经肽,被证明可以调控病毒感染的病理过程,并通过促炎、营养等多种作用参与病毒性角膜炎双眼角膜病变的进展,具有潜在的辅助诊断及治疗价值。因此本文对角膜神经和神经肽P物质在病毒性角膜炎中的改变及作用进行综述,为相关机制的基础研究及临床应用提供参考。
[Key word]
[Abstract]
Diseases like viral keratitis can harm corneal nerves, which are necessary for maintaining the health and functionality of the cornea. Recent research has shown that corneal nerve pathology affects the infected eye as well as the contralateral one, and that aberrant changes in sympathetic nerves can be seen, with the exception of sensory nerves that correspond to corneal sensation. However, apart from in vivo confocal microscopy and corneal sensation, there have been no additional prognostic indicators that allow clinicians to assess the severity of corneal nerve damage. While multiple functions of corneal nerves are mediated by neuropeptides, substance P, the first topical neuropeptide used in ocular clinical practice, was proved to regulate the process of viral infections, and it is involved in bilateral corneal pathologies through pro-inflammatory and neurotrophic functions in viral keratitis, so it may be used as a diagnostic biomarker or a therapeutic target. Therefore, this review summarized the changes and roles of corneal nerves as well as substance P in viral keratitis, which may serve as a reference for further study into associated mechanisms and clinical applications.
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[基金项目]
国家自然科学基金(No.U20A20363,81970776); 黑龙江省自然科学基金(No.LH2020H039)