【摘要】 在棘阿米巴性角膜炎的发病机制中, 免疫反应起了十分重要的作用。机体感染棘阿米巴原虫后产生相应的天然免疫与适应性免疫。正常人群中发现特异性棘阿米巴抗原并没有防止棘阿米巴角膜炎的再染与复发，这表明适应性免疫在棘阿米巴角膜炎发病过程中很难起保护作用。然而,天然免疫在抗棘阿米巴角膜炎的过程中起着至关重要的作用，粘膜免疫系统对其也具有显著的预防作用。深入了解棘阿米巴角膜炎的免疫机制，对指导治疗与改善预后有重要意义。我们就棘阿米巴角膜炎感染和免疫机制的研究进展作一综述。
【关键词】 棘阿米巴角膜炎；免疫机制；天然免疫
Recent advances in the immunological mechanism of acanthamoeba keratitis
XiuLi Lin, XueJun Zhu
Department of Ophthalmology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian Province, China
Abstract
Immune responses play an very important role in the pathogenesis of acanthamoeba keratitis. Infections of the body with acanthamoeba parasite would arouse corresponding innate immunity and adaptive immunity. Acanthamoebaspecific antigens detected in normal people can not prevent human from reinfection or recurrence. It was demonstrated that adaptive immune may hardly play protective roles in preventing the development of acanthamoeba keratitis. However, the innate natural immunity is crucial for the resolution of the disease, and common mucosal immune system has a significant effect in preventing acanthamoeba keratitis. Indepth understanding of the immunological mechanism of acanthamoeba keratitis may give more contributions on guiding treatment and improving the prognosis. This article summarized the research progress in acanthamoeba parasite infection and immunological mechanism of acanthamoeba keratitis.
KEYWORDS: acanthamoeba keratitis; immunological mechanism；innate immunity
0引言
阿米巴性角膜炎是一种严重的致盲性眼病。目前已证实至少有8 种棘阿米巴与角膜炎相关，其中主要为卡氏棘阿米巴和多噬棘阿米巴。棘阿米巴角膜炎的发生与一定的危险因素有关，主要包括配戴角膜接触镜、接触污染的水源和角膜外伤等[1]。在发达国家, 角膜接触镜是阿米巴性角膜炎的主要危险因素，而我国角膜外伤占危险因素的第一位。此外，宿主对感染的敏感性，粘膜免疫功能的异常，以及眼局部防御功能的低下也与角膜棘阿米巴感染的发生密切相关。
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