5问题展望 以上研究表明针对瘢痕形成信号通路中不同靶位的药物干预的确表现出一定的疗效,但是对于各类药物的应用尚无明确的定量化,同时我们也缺乏针对不同或相同靶位不同药物的联合应用或比较研究。由于在滤过性手术伤口愈合的过程中参与的细胞因子众多,各种细胞因子又可以同时激活多个信号传导途径,因此这些信号传导途径间不可避免的会相互交叉、相互影响,如TGFβ参与了多种信号通路的激活[10,24,45],而Rho通路自身活化同时参与对P38MAPK通路的的激活[33],在其他信号传导途径中活化的蛋白激酶也可以直接激活NFκB[46]。由于各条信号通路相互作用、交织呈网络共同影响瘢痕的发生发展,因此应该在充分研究各条通路的传导、作用机制的基础上,探索各条通路之间的关系,从整体上建立调控滤过道瘢痕形成的信号传导网络,从而找到干预瘢痕形成的最佳靶位。
【参考文献】 1 Tang GX, Tian AJ, Wang XB, et al. Clinical efficacy of subconjunctnal injection of Mitomycin C combined with acupuncture separation on the scarring filtration blebs. Int J Ophthalmol(Guoji Yanke Zazhi) 2008;8(12):25262527
2 Wynn TA. Cellular and molecular mechanisms of fibrosis. J Pathol 2008:214(2):199210
3 Khaw PT,Chang L,Wong TT, et al . Modulation of wound healing after glaucoma surgery. Curr Opin Ophthalmol 2001;12(2)143148
4 Atreides SP, Skuta GL, Reynolds AC. Wound healing modulation in glaucoma filtering surgery. Int Ophthalmol Clin 2004;44(2):61106
5 Lama PJ, Fechtner RD. Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol 2003;48(3):314346
6 Denk PO, Hoppe J, Hoppe V, et al . Effect of growth factor on the activation of human Tenons capsule fibroblasts. Curr Eye Res 2003;27(1):3544
7 Tomasek JJ, Cabbiani G, Hinz B, et al . Myofibroblasts and mechanoregulation of connective tissue remodeling. Nat Rev Mol Cell Biol 2002;3(5):349363
8 Cordeiro MF, Reichel MB, Gay JA, et al . Transforming growth factorbeta1,beta2, and beta3 in vivo: effects on normal and mitomycin Cmodulated conjunctival scarring. Invest Ophthalmol Vis Sci 1999;40(9):19751982
9 Corderio MF. Beyond mitomycin: TGFβ and wound healing. Prog Reyin Eye Res 2002;21(1):7589
10 Derynck R, Zhang YE. Smaddependent and Samdindependent pathways in TGFβ family signaling. Nature 2003;425(6958): 577584
上一页 [1] [2] [3] [4] [5] 下一页 |