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Augen-assoziiertes lymphatisches Gewebe (EALT) durchzieht die Augenoberfläche kontinuierlich von der Tränendrüse bis in die ableitenden Tränenwege

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Zusammenfassung

Hintergrund

Komponenten des Schleimhautimmunsystems (MALT) für die Intakterhaltung der Augenoberfläche befinden sich neben der Tränendrüse auch in der Konjunktiva (als CALT) und den ableitenden Tränenwegen (als LDALT). Ihr struktureller und funktioneller Zusammenhang ist allerdings noch ungeklärt.

Material und Methode

Es wurden normale Gewebe der Konjunktiva, der ableitenden Tränenwege und der Tränendrüse mittels Betrachtung von Aufhellungspräparaten, Histologie, Immunhistologie sowie Raster- und Transmissionselektronenmikroskopie untersucht.

Ergebnisse

Ein typisches diffuses lymphatisches Gewebe aus Effektorzellen des Immunsystems unter einem Epithel, das den IgA-Transporter SC enthält, liegt nicht isoliert in der Konjunktiva und den ableitenden Tränenwegen vor. Es verläuft anatomisch kontinuierlich vom periazinösen Bindegewebe der Tränendrüse entlang ihrer Ausführungsgänge in die Konjunktiva und setzt sich in den ableitenden Tränenwegen bis zur Nase fort. B-Lymphozyten wurden fast ausschließlich in Lymphfollikeln gefunden, die einer der Mehrzahl der Präparate seitengleich auftraten. Die Topographie von CALT korrespondiert mit der Position der Kornea bei geschlossenem Auge.

Schlussfolgerung

Das schleimhautassoziierte lymphatische Gewebe von Tränendrüse, Konjunktiva und ableitenden Tränenwegen bildet eine anatomische und funktionelle Einheit zur Immunprotektion der Augenoberfläche. Daher ist es als „Eye-Associated Lymphoid Tissue“ (EALT) in das Schleimhautimmunsystem des Körpers einzuordnen. EALT kann über Lymphfollikel Antigene der Augenoberfläche erkennen und über die regulierte Rezirkulation lymphatischer Zellen andere Organe sowie die Augenoberfläche einschließlich der Tränendrüse mit spezifischen Effektorzellen versorgen.

Abstract

Introduction

Components of the mucosal immune system (MALT) have been identified in the conjunctiva (as CALT) and the lacrimal drainage system (as LDALT). Their structural and functional relation with the established immune protection by the lacrimal gland is unclear.

Material and methods

Macroscopically normal and complete tissues of the conjunctiva, lacrimal drainage system and lacrimal gland from human body donors were investigated by analysis of translucent whole mounts, and using histology, immunohistology as well as scanning and transmission electron microscopy.

Results

A typical diffuse lymphoid tissue, composed of effector cells of the immune system (T-lymphocytes and IgA producing plasma cells) under an epithelium that contains the IgA transporter SC, is not isolated in the conjunctiva and lacrimal drainage system. It is anatomically continuous from the lacrimal gland along its excretory ducts into the conjunctiva and from there via the lacrimal canaliculi into the lacrimal drainage system. Lymphoid follicles occur in a majority (about 60%) and with bilateral symmetry. The topography of CALT corresponds to the position of the cornea in the closed eye.

Conclusion

These results show that the MALT of the lacrimal gland, conjunctiva and lacrimal drainage system constitute an anatomical and functional unit for immune protection of the ocular surface. Therefore it should be integrated as an “eye-associated lymphoid tissue” (EALT) into the MALT system of the body. EALT can detect ocular surface antigens by the lymphoid follicles and can supply other organs and the ocular surface including the lacrimal gland with specific effector cells via the regulated recirculation of lymphoid cells.

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Authors and Affiliations

  1. Augenklinik-Forschungslabor, Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Abteilung für Zellbiologie in der Anatomie, Medizinische Hochschule Hannover, Hannover

    E. Knop

  2. Abteilung für Zellbiologie in der Anatomie, Medizinische Hochschule Hannover, Hannover

    N. Knop

  3. Augenklinik-Forschungslabor, Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Str. 1, 13353 , Berlin

    E. Knop

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Die Untersuchungen dieser Arbeitsgruppe über das Schleimhautimmunsystem der Augenoberfläche wurden mit dem Sicca-Preis 2000 and 2002 der „Arbeitsgruppe Trockenes Auge“ des BVA ausgezeichnet.

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Knop, E., Knop, N. Augen-assoziiertes lymphatisches Gewebe (EALT) durchzieht die Augenoberfläche kontinuierlich von der Tränendrüse bis in die ableitenden Tränenwege. Ophthalmologe 100, 929–942 (2003). https://doi.org/10.1007/s00347-003-0936-6

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