摘要： 目的 观察IgG4相关性眼病（IgG4-ROD）泪腺病变的病理特点，探讨B细胞活化因子（BAFF）和增殖诱导配体（APRIL）在IgG4-ROD泪腺病变中的作用。方法 收集13例IgG4-ROD泪腺病变患者（15眼）的泪腺肿物为实验组，8例因其他疾病行眶内容物摘除患者（8眼）的正常泪腺组织为对照组。采用HE染色法观察泪腺的病理形态变化，免疫组织化学染色法检测泪腺中BAFF和APRIL的表达情况，并对二者表达水平进行相关性分析。结果 实验组泪腺出现弥漫性淋巴细胞和浆细胞浸润，广泛淋巴滤泡形成，纤维组织增生的病理改变。实验组泪腺中BAFF和APRIL的表达水平均明显高于对照组（均P < 0.05），且二者的表达呈正相关（P < 0.05）。结论 IgG4-ROD泪腺病变表现出淋巴细胞和浆细胞弥漫浸润、纤维组织增生的病理特点，这可能与BAFF和APRIL表达上调导致的免疫调节失衡有关。

IgG4相关性眼病泪腺病变的病理特点及BAFF和APRIL的表达

李培¹, 杨新吉², 高钰寒¹, 王海彬¹, 姜帅¹, 董微莉¹, 董志军¹

1. 承德医学院附属医院眼科, 河北 承德 067000;
2. 中国人民解放军总医院第三医学中心眼眶病研究所, 北京 100039

收稿日期:2022-05-19出版日期:2023-04-30发布日期:2023-04-15
通讯作者:董志军E-mail:dongzj1978@126.com
作者简介:李培(1993-),女,硕士研究生.
基金资助:河北省医学科学研究课题计划项目（20200366）；武警部队科研基金资助项目（wz2017016）


关键词: IgG4相关性眼病, 泪腺病变, 病理形态学, B细胞活化因子, 增殖诱导配体
Abstract: Objective To observe the pathological features of IgG4-related ophthalmic disease (IgG4-ROD) and investigate the role of B cell-activating factor of the TNF family (BAFF) and a proliferation-inducing ligand (APRIL) in the development of lacrimal gland lesions in IgG4-related ophthalmic disease. Methods Lacrimal gland tissues from 13 patients (15 eyes) with IgG4-ROD lacrimal gland lesions were collected as the experimental group, and normal lacrimal gland tissues from 8 patients (8 eyes) who underwent orbital content removal for other diseases were collected as the control group. Hematoxylin-eosin (HE) staining was used to observe the pathological features, and immunohistochemical staining was used to detect the expression of BAFF and APRIL. The correlation between the expression levels of BAFF and APRIL was analyzed. Results The pathological changes in the lacrimal glands of the experimental group included diffuse infiltration of lymphocytes and plasma cells, development of lymphoid follicles, and fibrous tissue hyperplasia. The expression levels of BAFF and APRIL were significantly higher in the experimental group than in the control group (both P < 0.05). The expressions of BAFF and APRIL were positively correlated in the experimental group (P < 0.05). Conclusion IgG4-ROD lacrimal gland lesions showed pathological features of diffuse infiltration by lymphocytes and plasma cells and fibrous tissue hyperplasia, which may be related to the imbalanced immune regulation caused by up-regulated expression of APRIL and BAFF.
Key words: IgG4-related ophthalmic disease, lacrimal gland lesion, pathological morphology, B cell-activating factor of the TNF family, a proliferation-inducing ligand
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