https://scholars.lib.ntu.edu.tw/handle/123456789/199601
Title: | 口服可溶性黑色素相關抗原以初級與次級預防實驗性自體免疫前葡萄膜炎 | Authors: | 林昌平 | Issue Date: | 2001 | Publisher: | 臺北市:國立臺灣大學醫學院眼科 | Abstract: | Uveitis is one of the leading causes of blindness, ft was estimated that 10% of the blindness was caused by uveitis in USA The treatment is mainly topical and systemic corticosteroid, and some of these patients may require the use of a variety of immunomodulatory, corticosteroid-sparing agents such as cyclosporine or cytotoxic agents. To date, clinically oriented approaches have centered on the administration of pharmacologic substances that have a nonspecific effect on the immune response The development of more effective treatment of organ-specific inflammatory disorders of putative autoirnmune origin is an ongoing goal in many specialties of clinical medicine. Recently, alternative therapeutic strategies have been suggested based on our better understanding of immunologic mechanisms that lead to organ-specific inflammatory responses. The induction of immunologic tolerance, defined as a state of specific immunologic unresponsiveness to an antigen after exposure to that antiger, is one such approach that has gained attention recently. One effective method of inducing immunologic tolerance is through the oral administration of antigen. The tolerance induced is called oral tolerance. One feature of oral tolerance is that “bystander” suppressive effect can be elicited to the organ or tissue that harboring the antigen. Oral tolerance has been tested in various animal models of autoimniune disorders, such as experimental autoimmune encephalomyelitis, collagen and adjuvant arthritis, experimental autoimmune diabetes, and experimental autcimmune uveitis. The effect of oral tolerance has also been tested in several clinical conditions in small scale with encouraging results, such as multiple sclerosis, rheumatoid arthritis, juvenile diabetes, Behcet’s disease and other intractable uveites. The most common disease entity of uveites in Taiwan is acute anterior uveitis (AAU). It is the recurrent nature of AAU that can result in blindness and socioeconomic loss though various complications, including glaucoma, cataract, and cystoid macular edema. Experimental autoimmune anterior uveitis (EAAU) has been established to simulate human AAU. It involves the use of melanin associated antigen extracted from bovine uveal tissue. We investigated the effect of oial tolerance in EAAU both as primary and secondary prevention, i.e. in unprimed and in primed animals. Unfortunately, the preparation of partially purified soluble melanin associated antigen in this report could not suppress experimental autoimmune anterior uveitis. 葡萄膜炎一般認為是一種自體免疫疾病。因反覆發生,造成角膜病變,白內障,青光眼或視網膜病變,而導致失明。其治療到目前止一直以局部或口服腎上類固醇或其它免疫抑制劑如環胞靈素為主要方法。這類治療因為是廣泛性,無選擇性的免疫抑制,而有各種相當的副作用。 口耐受性是指口服一種抗原,身體對該抗原的反應方式會有改變。以視網膜可溶性抗原為例,在路易氏鼠口服視網膜可溶性抗原數週後再於腳上注射網膜可溶性抗原以引發實驗性自體免疫葡萄膜炎。發現口服網膜可溶性抗原的實驗組不會發作,而對照組口服其它不相關抗原則會如預期地發病。其抑制用具抗原選擇性。最近因各種自體免疫疾病的動物模型的建立與應用,而能進一步探討口耐受性在治療與預防自體免疫疾病的可能性。有些疾病在動物模型與刁、規模人體試驗中獲得令人鼓舞的結果,如類風濕性關節炎,多發性硬節症,難纏的葡萄膜炎等。本報告中使用口服可溶性黑色素相關抗原來防止實驗性自體免疫前葡萄膜炎。因實驗性自體免疫前萄膜炎在發病三至六週可幾乎完全復原,再次施打黑色素相關抗原時可引起實驗性自體免疫前葡萄膜炎再發.因此可以研究在初次發病後讓路易士鼠口腹黑色素相關抗原,以研究口耐受性次級預防實驗自體免疫葡萄膜炎的可能陸。(而後者正是臨床上最希望能應用的) 結果是口服本實驗中粗製的可溶性黑色素相關抗原無法抑制實驗性自體免疫前葡萄膜炎。本實驗中未能純化並大量製造可溶性黑色素相關抗原是最可能的原因。可溶性黑色素相關抗原可以純化並大量製造後,口耐受性抑制實驗性自體免疫前萄膜炎仍是值得研究的題目。 |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/26720 | Other Identifiers: | 892314B002506 | Rights: | 國立臺灣大學醫學院眼科 |
Appears in Collections: | 醫學系 |
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892314B002506.pdf | 435.99 kB | Adobe PDF | View/Open |
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