6 HTLV-1相关眼病的分子生物学研究

     最近的两项研究报道利用分子生物学分析技术能有效诊断HTLV-1相关眼病 [14,23]。在第1项研究中，研究人员对先前提到的存在角膜周边瘢痕形成、基质变薄及结膜损害的牙买加男性患者取结膜活检，诊断为T细胞淋巴瘤[23]。对肿瘤细胞的分子分析采用显微切割及多聚酶链式反应，结果克隆出了T细胞受体，并在肿瘤细胞中发现HTLV-1 gag基因，支持了病毒在肿瘤形成中起一定作用的观点。另一项研究中，研究人员对伴有血管炎的牙买加女性ATL患者取血管周围肉芽肿浸润组织活检，应用显微切割及多聚酶链式反应分析T细胞，结果显示T细胞恶性肿瘤存在T细胞受体基因重排，并且发现了HTLV-1 pol基因，证实了HTLV-1可引起ATL[14]。

     总之，HTLV-1眼部表现的范围仍在扩大。由于HTLV-1相关性眼部疾病在起病时多无症状，后期发展多样化，建议对HTLV-1血清阳性患者应予常规眼科随访。多数HTLV-1相关性眼病与免疫调节有关，对皮质类固醇激素治疗反应良好，但是临床上仍会出现不易察觉的肿瘤病变，需要更为积极的治疗。要明确遗传及环境因素对不同地区不同人种HTLV-1患者的眼部表现的影响，还需进一步研究。

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