神经肽P物质与神经营养性角膜病变的关系及其应用现状

摘要

Neurotrophic keratopathy is caused by a variety of factors that damage the corneal sensory nerves,resulting in hypoesthesia of cornea,corneal dystrophy and inflammatory changes.The manifestations of neurotrophic keratopathy are recurrent or persistent corneal epithelial defects,delayed corneal wound healing,corneal ulcers and even perforation.There are still some difficulties in therapy targeting to nerve plerosis.Substance P,as a neurotransmitter,is expressed in ophthalmic nerves and many cell types,including corneal epithelial cells,stromal cells and immunological cells,and exerts its biological functions by activating intracellular signaling pathways.Recently,with the increasing researches of substance P,the treatment of neurotrophic keratopathy is gradually changing.This paper retrospected the clinical features and pathogenesis of neurotrophic keratopathy,summarized the association between substance P and neurotrophic keratopathy from the perspective of infection,surgery and systemic disease,and the prospects of substance P application in neurotrophic keratopathy.%神经营养性角膜病变是由多种因素损伤角膜感觉神经,导致角膜知觉减退,进而引起角膜营养障碍和炎症性改变,其常表现为复发性或持续性的角膜上皮缺损、角膜创伤愈合的延迟,产生角膜溃疡,甚至穿孔.目前临床靶向性治疗神经修复仍有一定难度.P物质作为一种神经递质,在眼部神经、角膜上皮细胞、角膜基质细胞及多种免疫细胞中广泛表达,通过启动胞内信号通路产生相应生物学功能.近年来,随着P物质相关研究增多,神经营养性角膜病变的治疗方式逐渐发生改变.本文回顾神经营养性角膜病变的临床特征及发病机制,从感染、手术及全身性疾病导致神经营养性角膜病变方面,总结神经肽P物质与神经营养性角膜病变关系及其应用前景.