Современные анатомо-физиологические основы поддержания прозрачности стромы роговицы

Статья представляет собой литературный обзор на тему современной концепции анатомо-физиологического строения и функционирования роговицы. Строгая морфологическая структура и гомеостаз ткани роговицы обеспечивают её прозрачность. Изучение механизмов, регулирующих постоянство внутренней среды ткани роговицы, позволяет приблизиться к  пониманию перспектив регенеративной терапии патологии стромы роговицы. В статье подробно рассматриваются роль и функциональный потенциал стромальных клеток роговицы, которые способны к обратной цитодифференцировке, что в первую очередь обеспечивает поддержание гомеостаза ткани и прозрачности роговицы. Функциональная активность клеток роговицы может изменяться по ряду причин, которые могут носить характер экзогенных, ятрогенных (травма, инфекции и  др.) либо быть эндогенными. К эндогенным причинам относят: патологии ауторегуляции клеток (например, ферментопатии); дефекты транспортных систем, приводящих к гипоксии тканей; расстройства нервно-гуморальной регуляции трофики. Физическая причина нарушения прозрачности роговицы заключается в увеличении рассеивания света. В статье приводится пять основных причин повышенного светорассеяния в непрозрачной роговице, а также представлен обзор основных веществ – компонентов и продуктов клеточного синтеза стромальных клеток роговицы: цитокинов и факторов роста (комплекс из сигнальной молекулы и рецептора SDF1/CXCR4, инсулиноподобный фактор роста 1, фактор некроза опухоли альфа, молекула межклеточной адгезии 1, эритропоэтин, нейротрофические факторы, и др). Таким образом, помутнение роговицы может вызываться как одним патогенетическим механизмом, так и комплексным воздействием нескольких факторов. Основные процессы регуляции тканевого гомеостаза направлены на поддержание уникальной морфологической структуры роговицы.

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