脈絡膜新生血管膜におけるマクロファージの役割

Role of macrophages in choroidal neovascular membrane

（P3-3-7）　硝子体手術により摘出した脈絡膜新生血管膜9例について，マクロファージと炎症性サイトカインでありかつ血管新生作用のあるIL-1b（interieukin-1b）とTNF-a （tumor necrosis factor-a）の分布について免疫組織化学的に検討した。マクロファージはCNVM （choroidal neovascuiar membrane）周囲のRPE層，間質，新生血管周囲に分布し，間質に多くみられた。IL-1bとTNF-aはRPE （retina-pigment epithelium）層，新生血管，間質細胞で陽性であり，IL-1bは主として新生血管，TNF-aは主にRPE層，新生血管において陽性であった。マクロファージは血管新生作用をもつIL-1bやTNF-aを産生することにより脈絡膜血管新生に関与する可能性が示唆された。

We performed immunohistochemical studies of choroidal neovascular membrane which was surgically excised in 9 eyes and which was paraffin-embedded. We tried to detect macrophages and inflammatory mediators, IL-1b and tumor necrosis factor-a (TNF-a), which are presumably derived from macrophages. Macrophages were present in the retinal pigment epithelium (RPE) layer, perivascular areas and, most conspicuously, in the stroma. Both cytokines were distributed in the RPE layer, newly formed vessels and stromal cells. I1-1b showed responderant expression in newly formed vessels. TNF-a was present in newly formed vessels and in the RPE layer with predominant immunoreactivity. Because both cytokines have angiogenic effects in vivo, co-localization of macrophages and these cytokines in the stroma strongly suggests the potential angiogenic role of this cell type in choroidal neovascular membrane.