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（4）转录水平调控治疗PVR。转录因子E2F促进细胞生长的某些基因在转录水平上有调控作用，通过阻断E2F的表达来抑制基因转录对治疗增生性疾病具有巨大潜力。Akimoto等[23]将人Tenon囊的成纤维细胞与携带有E2F 的日本凝血病毒的阳离子脂质体（HVJCL）共同培养，通过荧光染色显微镜、RTPCD等方法观察实验结果，表明HVJCL促进外部寡核苷酸转入人成纤维细胞， decoy抑制了cmyc、cdc2等细胞周期相关基因，增生性细胞核抗原和脱氢叶酸盐还原酶等mRNA的共同表达。
4 讨 论
PVR的细胞学基础及发病机制被众多学者广泛关注，机体生长因子的平衡性是关键因素，生长因子与抑制因子组成了一个庞大的系统，各种因子通过特定的途径阻断或抑制PVR的发生过程，从而发挥预防与治疗作用。目前众多因子中PDGF被证明是最有前途的一种抑制因子，如何进一步开发与利用PDGF，还需大量的基础与临床研究。
手术治疗虽然是一种有效的去除PVR增生膜的方法，但是复发率高，并有血眼屏障的破坏、炎症反应重的缺点，仍然不能解决大多数患者最终失明的结果。药物为PVR的治疗提供了广阔的前景，但由于抗细胞代谢增生的药物存在不同程度毒性，至今仍然难以应用于临床。
基因治疗似乎成为治疗PVR的一种有效方法，但PVR的基因治疗还存在很多问题。PVR的基因治疗目前还处于动物实验阶段，PVR基因治疗中所用的启动子在视网膜细胞中表达率难以掌握，而且体外基因转移也是一个重要的研究领域，人视网膜细胞在体外进行长期培养与传代，细胞的生物学特性是否改变仍然值得研究。在PVR的基因治疗研究中，采用最多的是逆转录病毒载体，其安全性一直引起关注。另外，基因治疗过程中，必须要考虑的是引入载体的基因表达能力，是否可调节以及它们对机体的潜在毒副作用。
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（郑州大学第一附属医院眼科，河南 郑州 450052） 上一页 [1] [2] |
