1
|
Layús BI, Gómez MA, Cazorla SI, Rodriguez AV. A Postbiotic Formulation of Lactiplantibacillus plantarum CRL 759 Attenuates Endotoxin Induced Uveitis. Ocul Immunol Inflamm 2024:1-10. [PMID: 38335476 DOI: 10.1080/09273948.2024.2310173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/21/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To evaluate the anti-inflammatory activity of a cell-free supernatant from Lactiplantibacillus plantarum CRL 759, in phosphate buffer modified according to Sorensen called POF-759. METHODS The activity of POF-759 administered by means of eye drops was evaluated on animals subcutaneously injected with the lipopolysaccharide animals in which uveitis was induced by a subcutaneous injection of lipopolysaccharide (EIU). Clinical signs of ocular inflammation, cytokines and proteins were examined in the aqueous humor. Additionally, cellular infiltration was evaluated by histopathological analysis. RESULTS The new postbiotic administered locally decreases signs of ocular damage, the number of infiltrating cells in the anterior and posterior chambers, the proinflammatory mediators and the proteins in the aqueous humor on mice with EIU. CONCLUSIONS Our results provide an impetus to relieve ocular inflammation and to identify and develop preventive and therapeutic approaches, to avoid deterioration and to maintain healthy eyes on inflammatory processes.
Collapse
Affiliation(s)
- Bárbara Ivana Layús
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Argentina
| | - María Alejandra Gómez
- Servicio de Oftalomolgía, Hospital Ángel C. Padilla, San Miguel de Tucumán, Argentina
| | - Silvia Inés Cazorla
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Argentina
- Cátedra de Inmunología, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina
| | - Ana Virginia Rodriguez
- Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Argentina
| |
Collapse
|
2
|
Kalogeropoulos D, Kanavaros P, Vartholomatos G, Moussa G, Kalogeropoulos C. Cytokines in Immune-mediated "Non-infectious" Uveitis. Klin Monbl Augenheilkd 2023. [PMID: 38134911 DOI: 10.1055/a-2202-8704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Uveitis is a significant cause of ocular morbidity and accounts for approximately 5 - 10% of visual impairments worldwide, particularly among the working-age population. Infections are the cause of ~ 50% cases of uveitis, but it has been suggested that infection might also be implicated in the pathogenesis of immune-mediated "non-infectious" uveitis. There is growing evidence that cytokines (i.e., interleukins, interferons, etc.) are key mediators of immune-mediated "non-infectious" uveitis. For example, activation of the interleukin-23/interleukin-17 signalling pathway is involved in immune-mediated "non-infectious" uveitis. Studies in animal models have been important in investigating the role of cytokines in uveitis. Recent studies of clinical samples from patients with uveitis have allowed the measurement of a considerable array of cytokines even from very small sample volumes (e.g., aqueous and vitreous humour). The identification of complex patterns of cytokines may contribute to a better understanding of their potential pathogenetic role in uveitis as well as to an improved diagnostic and therapeutic approach to treat these potentially blinding pathologies. This review provides further insights into the putative pathobiological role of cytokines in immune-mediated "non-infectious" uveitis.
Collapse
Affiliation(s)
| | - Panagiotis Kanavaros
- Anatomy-Histology-Embryology, University of Ioannina, Faculty of Medicine, Greece
| | - Georgios Vartholomatos
- Hematology Laboratory, Unit of Molecular Biology, University General Hospital of Ioannina, Greece
| | - George Moussa
- Ophthalmology, Birmingham and Midland Eye Centre, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | | |
Collapse
|
3
|
Lin TY, Lai YF, Chien WC, Chen YH, Chung CH, Chen JT, Chen CL. Impact of Endophthalmitis on the Risk of Acute Myocardial Infarction in Ankylosing Spondylitis Patients: A Population-Based Retrospective Cohort Study. J Clin Med 2023; 12:jcm12031211. [PMID: 36769859 PMCID: PMC9918242 DOI: 10.3390/jcm12031211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/06/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Many studies have demonstrated an increased cardiovascular (CV) risk in ankylosing spondylitis (AS) patients. Nevertheless, the influence of an endophthalmitis episode toward the future risks of acute myocardial infarction (AMI) in AS patients has been unclear. The objective of this study was to explore the impact of endophthalmitis on AMI risk in this particular patient population by a population-based retrospective cohort study with a follow-up period up to 16 years. Univariate and multivariate Cox regression analyses were used for the risk evaluation and the results were presented as crude and adjusted hazard ratios (HRs). Overall, we enrolled 557 AS patients with endophthalmitis as the study cohort and selected another 2228 matched AS patients without endophthalmitis as the comparison cohort. Comparing the comparison cohort, the study cohort showed a significantly higher overall AMI incidence rate with an adjusted HR of 1.631 (p < 0.001). In conclusion, endophthalmitis increased the risk of AMI in AS patients after adjusting for possible clinical confounders. Special attention and work-up are required for physicians when encountering a history of endophthalmitis in these special patient populations, especially when they are comorbid with other potential CV risk factors.
Collapse
Affiliation(s)
- Ting-Yi Lin
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Yi-Fen Lai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei City 11490, Taiwan
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Ching-Long Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan
- Correspondence: ; Tel.: +886-953-665-793; Fax: +886-8792-7164
| |
Collapse
|
4
|
Kumar A, Singh R, Sharma RK, Sharma SP, Agarwal A, Gupta V, Singh R, Katoch D, Singh N. Correlation of angiogenic growth factors and inflammatory cytokines with the clinical phenotype of ocular tuberculosis. Graefes Arch Clin Exp Ophthalmol 2022; 261:1369-1380. [PMID: 36547708 DOI: 10.1007/s00417-022-05943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/08/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To determine the correlation of angiogenic growth factors and inflammatory cytokines with the clinical phenotype of ocular tuberculosis (OTB). METHODS Vitreous fluid was analysed for cytokines in patients with OTB and non-OTB uveitis using multiplex fluorescent bead-based flow cytometric assay. The clinical phenotypes were recorded and correlated with vitreous biomarkers. RESULTS Vitreous humour from OTB patients had elevated levels of interleukin-10 (IL-10), IL-17-A, interferon-gamma (IFN-γ), and tumour necrosis factor-alpha (TNF-α). Angiopoietin (Ang-2) levels were higher in the panuveitis phenotype. OTB posterior uveitis phenotype had relatively higher vascular endothelial growth factor (VEGF) levels and lower fibroblast growth factor (FGF) levels. Additionally, eyes with choroiditis and vasculitis had elevated levels of VEGF and Ang-2 with FGF downregulation. Both IFN-γ and IL-10 were upregulated in the choroiditis phenotype of OTB. CONCLUSION Angiogenic growth factors and inflammatory cytokines were altered in the vitreous humour of OTB patients. IFN-γ, VEGF, and IL-10 levels are increased in choroiditis and vasculitis phenotypes. Receiver operating characteristic (ROC) curve analysis further emphasized the importance of the IFN-γ assay in the diagnosis of OTB.
Collapse
|
5
|
Could different aqueous humor and plasma cytokine profiles help differentiate between ocular sarcoidosis and ocular tuberculosis? Inflamm Res 2022; 71:949-961. [PMID: 35763079 DOI: 10.1007/s00011-022-01601-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/07/2022] [Accepted: 06/10/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE AND DESIGN A cross-sectional single-center study was conducted to assess cytokine levels in aqueous humor (AH) and plasma of three different uveitis entities: definite ocular sarcoidosis (OS), definite OS associated with QuantiFERON®-TB Gold test positivity (Q + OS) and presumed tubercular uveitis (TBU). SUBJECTS Thirty-two patients (15 OS, 5 Q + OS, 12 TBU) were included. METHODS Quantification of selected cytokines was performed on blood and AH samples collected before starting any treatment. Statistical analysis was conducted using the Kruskal-Wallis test, the Mann-Whitney or Fisher test and the Principal Component Analysis (PCA). RESULTS IL-6, IL-8 and IP-10 levels were higher in AH samples than in peripheral blood. In AH samples, BLC, IL-8 and IP-10 were significantly higher in definite OS than in presumptive TBU. There were no statistically significant differences in terms of cytokine levels between Q + OS and presumptive TBU. PCA showed a similar cytokine pattern in the latter two groups (IFNγ, IL-15, IL-2, IP-10, MIG), while the prevalent expression of BLC, IL-10 and MIP-3 α was seen in definite OS. CONCLUSIONS The different AH and plasma cytokine profiles observed in OS compared to Q + OS and TBU may help to differentiate OS from TBU in overlapping clinical phenotypes of granulomatous uveitis (Q + OS).
Collapse
|
6
|
Lin TY, Lai YF, Chien WC, Chen YH, Sun CA, Chung CH, Chen JT, Chen CL. Association Between Endophthalmitis and the Incidence of Acute Coronary Syndrome in Patients With Ankylosing Spondylitis: A Nationwide, Population-Based Cohort Study. Front Immunol 2022; 13:843796. [PMID: 35401539 PMCID: PMC8990883 DOI: 10.3389/fimmu.2022.843796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Ankylosing spondylitis (AS) is a risk factor for acute coronary syndrome (ACS). However, the influence of infectious insults, such as endophthalmitis, on the risk of ACS among AS patients has not been studied yet. In this study, we aimed to investigate the relationship between endophthalmitis in patients with AS and the incidence of ACS. Methods This retrospective cohort study extracted medical records from the Taiwan Longitudinal Health Insurance Database (LHID) from January 1, 2000, to December 31, 2015. The primary outcome was the incidence of ACS. Univariate and multivariate Cox regression analyses with and without Fine and Gray’s competing risk model and Kaplan–Meier survival curve were used for the analyses. Spearman’s rank correlation coefficient was performed for sensitivity analysis. Results We identified 530 AS patients with endophthalmitis and 2,120 AS patients without endophthalmitis for comparison. The incidence rate of endophthalmitis in our study population was 2.66%. The overall incidence rate of ACS was 1,595.96 per 100,000 person-years in AS patients with endophthalmitis and 953.96 per 100,000 person-years in AS patients without endophthalmitis (adjusted HR = 1.787; 95% CI: 1.594–2.104, p < 0.001). In comparison to those without comorbidities, higher adjusted HRs were found in AS patients with endophthalmitis and comorbidities such as diabetes mellitus, hyperlipidemia, hypertension, cerebrovascular accident, congestive heart failure, chronic obstructive pulmonary disease, asthma, and coronary artery disease. Besides, the age ≥ 60 years revealed a high risk for ACS in AS patients with endophthalmitis. Conclusion Endophthalmitis was found to be an independent risk factor for ACS in patients with AS. Further clinical studies are required to elucidate the underlying mechanisms and status of systemic inflammation during endophthalmitis.
Collapse
Affiliation(s)
- Ting-Yi Lin
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Yi-Fen Lai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei City, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.,Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei City, Taiwan
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Ching-Long Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| |
Collapse
|
7
|
Kasper M, Heming M, Schafflick D, Li X, Lautwein T, Meyer zu Horste M, Bauer D, Walscheid K, Wiendl H, Loser K, Heiligenhaus A, Meyer zu Hörste G. Intraocular dendritic cells characterize HLA-B27-associated acute anterior uveitis. eLife 2021; 10:e67396. [PMID: 34783307 PMCID: PMC8594918 DOI: 10.7554/elife.67396] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 09/21/2021] [Indexed: 12/30/2022] Open
Abstract
Uveitis describes a heterogeneous group of inflammatory eye diseases characterized by infiltration of leukocytes into the uveal tissues. Uveitis associated with the HLA haplotype B27 (HLA-B27) is a common subtype of uveitis and a prototypical ocular immune-mediated disease. Local immune mechanisms driving human uveitis are poorly characterized mainly due to the limited available biomaterial and subsequent technical limitations. Here, we provide the first high-resolution characterization of intraocular leukocytes in HLA-B27-positive (n = 4) and -negative (n = 2) anterior uveitis and an infectious endophthalmitis control (n = 1) by combining single-cell RNA-sequencing with flow cytometry and protein analysis. Ocular cell infiltrates consisted primarily of lymphocytes in both subtypes of uveitis and of myeloid cells in infectious endophthalmitis. HLA-B27-positive uveitis exclusively featured a plasmacytoid and classical dendritic cell (cDC) infiltrate. Moreover, cDCs were central in predicted local cell-cell communication. This suggests a unique pattern of ocular leukocyte infiltration in HLA-B27-positive uveitis with relevance to DCs.
Collapse
Affiliation(s)
- Maren Kasper
- Ophtha-Lab, Department of Ophthalmology, and Uveitis Centre at St. Franziskus HospitalMünsterGermany
| | - Michael Heming
- Department of Neurology with Institute of Translational Neurology, University Hospital MuensterMuensterGermany
| | - David Schafflick
- Department of Neurology with Institute of Translational Neurology, University Hospital MuensterMuensterGermany
| | - Xiaolin Li
- Department of Neurology with Institute of Translational Neurology, University Hospital MuensterMuensterGermany
| | - Tobias Lautwein
- Department of Neurology with Institute of Translational Neurology, University Hospital MuensterMuensterGermany
| | | | - Dirk Bauer
- Ophtha-Lab, Department of Ophthalmology, and Uveitis Centre at St. Franziskus HospitalMünsterGermany
| | - Karoline Walscheid
- Ophtha-Lab, Department of Ophthalmology, and Uveitis Centre at St. Franziskus HospitalMünsterGermany
- Department of Ophthalmology, University of Duisburg-EssenEssenGermany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University Hospital MuensterMuensterGermany
| | - Karin Loser
- Department of Human Medicine, University of OldenburgOldenburgGermany
| | - Arnd Heiligenhaus
- Ophtha-Lab, Department of Ophthalmology, and Uveitis Centre at St. Franziskus HospitalMünsterGermany
- University of Duisburg-EssenEssenGermany
| | - Gerd Meyer zu Hörste
- Department of Neurology with Institute of Translational Neurology, University Hospital MuensterMuensterGermany
| |
Collapse
|
8
|
Yang H, Khan S, Sun A, Bai Q, Cheng H, Akhtari K. Enhancement of interferon gamma stability as an anticancer therapeutic protein against hepatocellular carcinoma upon interaction with calycosin. Int J Biol Macromol 2021; 185:813-820. [PMID: 34186122 DOI: 10.1016/j.ijbiomac.2021.06.159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/13/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
The stability of IFN-γ as a therapeutic protein can play a key role on its anticancer effects. Herein, we explored the thermodynamic parameters and conformational stability of IFN-γ in the presence of calycosin, the main active compound of Radix astragali, by different biophysical and theoretical analysis. Afterwards, the improved anticancer effects of IFN-γ-calycosin interaction relative to IFN-γ alone were assessed on hepatocellular carcinoma (HepG2) cell line by MTT and caspase assays. ITC data indicated that upon interaction of calycosin with IFN-γ the binding and thermodynamic parameters were as follows: Kd = 1.9 μM, ΔG° = -32.45 kJ/mol, ΔH° = -11.91 kJ/mol, and TΔS° = 20.54 kJ/mol. ANS/synchronous fluorescence, CD and UV-Vis spectroscopy studies indicated that the interaction between calycosin and IFN-γ caused the folding of the IFN-γ backbone in to a more packed structure with enhanced α-helix content and higher melting temperature (Tm) value. The spectroscopic outcomes were then verified by molecular docking and molecular dynamic analysis. It was also shown that after incubation of the IFN-γ samples at 50 °C for 60 min in the presence of calycosin (5 μM), the IFN-γ-calycosin system showed a significant antiproliferative effects against hepatocellular carcinoma (HepG2) cells through caspase-9/3 activation and this anticancer effect was more pronounced than free IFN-γ. This data may provide useful information about the development of IFN-γ-based therapeutic platforms.
Collapse
Affiliation(s)
- Huiyu Yang
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
| | - Suliman Khan
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Aimin Sun
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, PR China
| | - Qian Bai
- Department of Anesthesiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
| | - Haowei Cheng
- Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, PR China
| | - Keivan Akhtari
- Department of Physics, University of Kurdistan, Sanandaj, Iran
| |
Collapse
|
9
|
Balamurugan S, Das D, Hasanreisoglu M, Toy BC, Akhter M, Anuradha VK, Anthony E, Gurnani B, Kaur K. Interleukins and cytokine biomarkers in uveitis. Indian J Ophthalmol 2021; 68:1750-1763. [PMID: 32823391 PMCID: PMC7690463 DOI: 10.4103/ijo.ijo_564_20] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Interleukins and cytokines are involved in the pathogenesis of uveitis of heterogeneous origin. Understanding the basics of the ocular immune privilege is a fulcrum to discern their specific role in diverse uveitis to potentially translate as therapeutic targets. This review attempts to cover these elements in uveitis of infectious, noninfectious and masquerade origin. Insights of the molecular targets in novel therapy along with the vision of future research are intriguing.
Collapse
Affiliation(s)
- S Balamurugan
- Uveitis Services, Aravind Eye Hospital, Pondicherry, India
| | - Dipankar Das
- Department of Ocular Pathology, Uveitis and Neuro-Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Murat Hasanreisoglu
- Department of Ophthalmology, Koc University Medical School; Koc University Center for Translational Medicine Research, Istanbul; Department of Ophthalmology, Gazi University, School of Medicine, Ankara, Turkey
| | - Brian C Toy
- Assistant Professor of Clinical Ophthalmology, USC Roski Eye Institute, Los Angeles, USA
| | | | - V K Anuradha
- Uveitis Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Eliza Anthony
- Uveitis Services, Aravind Eye Hospital, Chennai, Tamil Nadu, India
| | | | | |
Collapse
|
10
|
Bansal R, Dogra M, Chawla R, Kumar A. Pars plana vitrectomy in uveitis in the era of microincision vitreous surgery. Indian J Ophthalmol 2021; 68:1844-1851. [PMID: 32823401 PMCID: PMC7690537 DOI: 10.4103/ijo.ijo_1625_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Pars plana vitrectomy (PPV) in uveitis is indicated for various diagnostic and therapeutic indications. With the advent of microincision vitreous surgery (MIVS), the use of PPV in uveitis has increased with a wider spectrum of indications due to shorter surgical time, less patient discomfort, less conjunctival scarring, and a decreased rate of complications as compared to standard 20G vitrectomy. Because of faster post-operative recovery in terms of visual improvement and reduction of inflammation, and reduced duration of systemic corticosteroids, MIVS has gained popularity in uveitis as an adjunctive therapy to the standard of care medical therapy. The safety and efficacy of MIVS is related to the emerging vitrectomy techniques with better and newer cutters, illuminating probes, and accessory instruments. Because of the instrumentation and fluidics of MIVS, PPV is emerging as a safe and useful alternative for diagnostic challenges in uveitis, aiding in earlier diagnosis and better outcome of inflammatory disease, even in the presence of severe and active inflammation, which was once considered a relative contraindication for performing vitreous surgery. However, for surgical interventions for therapeutic indications and complications of uveitis, it is advisable to achieve an optimum control of inflammation for best results. The increasing reports of the use of MIVS in uveitis have led to its wider acceptance among clinicians practicing uveitis.
Collapse
Affiliation(s)
- Reema Bansal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohit Dogra
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rohan Chawla
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Atul Kumar
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
11
|
Guo K, Zhang X. Cytokines that Modulate the Differentiation of Th17 Cells in Autoimmune Uveitis. J Immunol Res 2021; 2021:6693542. [PMID: 33816637 PMCID: PMC7990547 DOI: 10.1155/2021/6693542] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/01/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Increasing evidence has suggested that T helper 17 (Th17) cells play a central role in the pathogenesis of ocular immune disease. The association between pathogenic Th17 cells and the development of uveitis has been confirmed in experimental and clinical studies. Several cytokines affect the initiation and stabilization of the differentiation of Th17 cells. Therefore, understanding the mechanism of related cytokines in the differentiation of Th17 cells is important for exploring the pathogenesis and the potential therapeutic targets of uveitis. This article briefly describes the structures, mechanisms, and targeted drugs of cytokines-including interleukin (IL)-6, transforming growth factor-β1 (TGF-β1), IL-1β, IL-23, IL-27, IL-35, IL-2, IL-4, IL-21, and interferon (IFN)-γ-which have an important influence on the differentiation of Th17 cells and discusses their potential as therapeutic targets for treating autoimmune uveitis.
Collapse
Affiliation(s)
- Kailei Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Xiaomin Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| |
Collapse
|
12
|
Igarashi N, Honjo M, Kaburaki T, Aihara M. Effects of ROCK Inhibitors on Apoptosis of Corneal Endothelial Cells in CMV-Positive Posner-Schlossman Syndrome Patients. Invest Ophthalmol Vis Sci 2021; 61:5. [PMID: 32749463 PMCID: PMC7441372 DOI: 10.1167/iovs.61.10.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose To examine the role of aqueous tumor necrosis factor α (TNF-α)–RhoA–Rho kinase (ROCK) signaling in cytomegalovirus (CMV)-induced apoptosis and the barrier function of cultured human corneal endothelial cells (hCECs) in CMV-positive Posner–Schlossman syndrome (CMV+/PSS) patients. Methods Aqueous levels of TNF-α, IL-8, IL-10, and several other cytokines in 19 CMV+/PSS patients and 20 healthy control subjects were quantitated using a multiplex assay. The expression of active RhoA in hCECs post-CMV infection was determined using western blotting (WB). The expression levels of TNF-α and nuclear factor kappa B (NF-κB) in CMV-infected hCECs were examined by immunocytochemistry (ICC) and WB with and without ROCK inhibitors. The apoptotic rate and barrier integrity in CMV-infected hCECs were also examined. Results The expression levels of TNF-α, monocyte chemoattractant protein-1 (MCP-1), IL-8, and IL-10 were upregulated in the aqueous humor of CMV+/PSS patients, and among these upregulated cytokines aqueous TNF-α was negatively correlated with the number of corneal endothelial cells. In CMV-infected hCECs, upregulation of TNF-α and NF-κB was determined by WB and ICC. In hCECs, CMV infection induced apoptosis and significantly impaired cell–cell contacts, effects that were attenuated by treatment with a ROCK inhibitor. Conclusions Aqueous TNF-α was upregulated in CMV+/PSS patients, which may have triggered corneal endothelial cell loss. Modulation of TNF-α, including its downstream Rho–ROCK signaling, could serve as a novel treatment modality for corneal endothelial cell loss in CMV+/PSS patients.
Collapse
|
13
|
Simsek M, Ozdal PC. Inflammatory markers of complete blood count in Fuchs uveitis syndrome. Can J Ophthalmol 2020; 56:197-202. [PMID: 33232679 DOI: 10.1016/j.jcjo.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/21/2020] [Accepted: 10/25/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate inflammatory indices of complete blood count (CBC) in patients with Fuchs uveitis syndrome (FUS), and to compare the results with healthy individuals. DESIGN Cross-sectional, comparative study. PARTICIPANTS A total of 140 participants were included in the study and divided into 2 groups: 70 patients diagnosed with FUS (FUS group) and 70 healthy individuals (control group). METHODS The groups were compared in terms of ocular examination findings and CBC parameters. The independent samples t test was used to examine variables between the groups. The Pearson correlation test was performed to analyze correlation among the severity of anterior chamber reaction, duration of FUS, and CBC indices. RESULTS The mean lymphocyte count and lymphocyte-to-monocyte ratio (LMR) were significantly higher in the FUS group than in the control group (p = 0.001 and p < 0.001, respectively). The mean monocyte count and neutrophil-to-lymphocyte ratio (NLR) were significantly lower in the FUS group than in the control group (p = 0.010 and p = 0.003, respectively). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for LMR was 0.834, with a sensitivity of 82.6% and a specificity of 80.0%. The AUC for NLR was 0.789, with a sensitivity of 71.2% and a specificity of 70.0%. LMR was positively correlated with duration of FUS (p = 0.001, r = 0.574). CONCLUSIONS Our findings suggest that decreased NLR and increased LMR values may be markers indicating impaired blood-aqueous barrier function in FUS.
Collapse
Affiliation(s)
- Mert Simsek
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.
| | - Pinar Cakar Ozdal
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
14
|
Tear cytokines as potential biomarkers in non-infectious uveitis: post hoc analysis of a randomised clinical trial. Graefes Arch Clin Exp Ophthalmol 2020; 258:1813-1819. [PMID: 32377822 DOI: 10.1007/s00417-020-04707-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/08/2020] [Accepted: 04/15/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The study aimed to evaluate cytokines in tears as potential biomarkers in non-infectious uveitis. METHODS Tear samples were obtained using Schirmer strips from 50 patients enrolled in a randomised controlled study of simvastatin in non-infectious uveitis and from a control group of 30 healthy participants. The concentrations of IL-6, IL-8, IL-10, and IFN-γ in tears were measured at the study's baseline and again after 8 weeks of treatment using commercial enzyme-linked immunosorbent assay kits. RESULTS The concentrations of tears IL-6 and IL-10 were increased in patients with non-infectious uveitis in comparison with the healthy participants. Longer disease duration was associated with elevated levels of IL-6. The concentrations of the studied cytokines in tears did not correlate with the extent of eye inflammation at baseline. No link between the changes in cytokine levels and changes in clinical parameters during treatment was observed. Baseline IL-10 concentrations independently predicted the development of the clinical response to treatment at weeks 4 and 8. CONCLUSION Although elevated in non-infectious uveitis patients, tear cytokine levels do not correlate with eye inflammation and are not sensitive to change after treatment. However, the level of IL-10 may be a predictive biomarker of response to the treatment of uveitis. TRIAL REGISTRATION NCT04183387.
Collapse
|
15
|
Involvement of autotaxin in the pathophysiology of elevated intraocular pressure in Posner-Schlossman syndrome. Sci Rep 2020; 10:6265. [PMID: 32286414 PMCID: PMC7156668 DOI: 10.1038/s41598-020-63284-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 03/27/2020] [Indexed: 12/14/2022] Open
Abstract
To examine whether autotaxin (ATX) in the aqueous humor causes elevated intraocular pressure (IOP) in patients with Posner-Schlossman syndrome (PSS). ATX and transforming growth factor beta (TGF-β) in the aqueous humor were quantified in PSS patients. The expression of ATX and TGF-β in cytomegalovirus (CMV)-infected-human trabecular meshwork (hTM) cells was examined. Biological changes in hTM cells and monkey Schlemm’s canal endothelial (SCE) cells cultured in the conditioned medium of CMV-infected hTM cells were analyzed. The expression of ATX and TGF-β1 was upregulated in the aqueous humor of CMV-positive PSS patients, and the level of ATX in the aqueous humor was positively correlated with IOP. CMV infection upregulated ATX and TGF-β1 in hTM cells. The conditioned medium induced fibrotic changes in hTM cells and reduced SCE permeability, which was attenuated by an ATX inhibitor, a lysophosphatidic acid receptor antagonist, and a Rho kinase inhibitor. ATX in the aqueous humor induced by CMV infection may trigger elevated IOP. Modulating ATX activity may be a novel treatment modality for PSS.
Collapse
|
16
|
Bonacini M, Soriano A, Cimino L, De Simone L, Bolletta E, Gozzi F, Muratore F, Nicastro M, Belloni L, Zerbini A, Fontana L, Salvarani C, Croci S. Cytokine Profiling in Aqueous Humor Samples From Patients With Non-Infectious Uveitis Associated With Systemic Inflammatory Diseases. Front Immunol 2020; 11:358. [PMID: 32210963 PMCID: PMC7077343 DOI: 10.3389/fimmu.2020.00358] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/14/2020] [Indexed: 12/14/2022] Open
Abstract
Non-infectious uveitis are intraocular inflammatory conditions caused by dysregulated activation of the immune response without any detectable infectious agents. The aim of this study was to explore potential markers and therapeutic targets for two distinct types of non-infectious uveitis associated with Behçet's disease (BD) and Vogt Koyanagi Harada (VKH) disease. Concentrations of 27 cytokines were investigated in aqueous humor (AH) samples from patients with active uveitis vs. healthy controls (HC) (n = 10 patients with BD-associated uveitis; n = 10 patients with VKH-associated uveitis; n = 10 HC) using the Bio-Plex ProTM human cytokine group I panel. Additionally, leukocytes in AH samples were counted with hemocytometers and characterized by flow cytometry. Eleven cytokines were differentially expressed between patients with uveitis and HC with a median concentration greater than 10 pg/ml. IL-6, IP-10, G-CSF, and IFNγ showed higher concentrations in AH samples from both BD and VKH patients while IL-2, IL-8, IL-13, TNFα, eotaxin, IL-1ra showed statistically significant higher concentrations only in AH samples from BD patients. GM-CSF was the sole cytokine with an opposite profile showing decreased levels in AH samples from BD patients. IL-1ra and IL-6 were detected at higher frequencies in AH samples from BD and VKH patients compared with those from HC while IFNγ and TNFα were not detected in HC. The concentrations of IL-6, IL-8, IP-10, G-CSF, IFNγ, TNFα, eotaxin, IL-1ra positively correlated with the concentrations of leukocytes in AH, suggesting that such cytokines can be produced by immune cells and/or attract and/or promote proliferation and survival of immune cells in these types of uveitis. The correlation matrix of cytokine concentrations in AH samples revealed that IFNγ, TNFα, eotaxin, IL-6, G-CSF highly correlated each other. The ratios of cytokine concentrations between AH and plasma intra-individuals showed that IL-2, IL-6, IP-10, GM-CSF were increased intraocularly. In conclusion, AH sampling followed by multiplex analysis of cytokines should be fostered in non-infectious uveitis to identify cytokines dysregulated intraocularly in each individual laying the groundwork for precision medicine.
Collapse
Affiliation(s)
- Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Soriano
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca De Simone
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elena Bolletta
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Muratore
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Nicastro
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Belloni
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Zerbini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Fontana
- Ophthalmology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Surgery, Medicine, Dentistry and Morphological Sciences, With Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| |
Collapse
|
17
|
Liu Y, Kitaichi N, Wu D, Hase K, Satoh M, Iwata D, Namba K, Kanda A, Noda K, Itai A, Iwabuchi K, Ishida S. Attenuation of experimental autoimmune uveoretinitis in mice by IKKβ inhibitor IMD-0354. Biochem Biophys Res Commun 2020; 525:589-594. [PMID: 32115150 DOI: 10.1016/j.bbrc.2020.02.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/18/2020] [Indexed: 10/24/2022]
Abstract
Uveitis is a sight-threatening intraocular inflammatory disease that accounts for almost 10% of blindness worldwide. NF-κB signaling plays pivotal roles in inflammatory diseases. We have reported that IMD-0354, which inhibits NF-κB signaling via selective blockade of IKK-β, suppresses inflammation in several ocular disease models. Here, we examined the therapeutic effect of IMD-0354 in an experimental autoimmune uveoretinitis (EAU) model, a well-established animal model for endogenous uveitis in humans. Systemic administration of IMD-0354 significantly suppressed the clinical and histological severity, inflammatory edema, and the translocation of NF-κB p65 into the nucleus of retinas in EAU mice. Furthermore, IMD-0354 treatment significantly inhibited the levels of several Th1/Th17-mediated pro-inflammatory cytokines in vitro. Our current data demonstrate that inhibition of IKKβ with IMD-0354 ameliorates inflammatory responses in the mouse EAU model, suggesting that IMD-0354 may be a promising therapeutic agent for human endogenous uveitis.
Collapse
Affiliation(s)
- Ye Liu
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Nobuyoshi Kitaichi
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan.
| | - Di Wu
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Keitaro Hase
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Masashi Satoh
- Department of Immunology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Daiju Iwata
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kenichi Namba
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Atsuhiro Kanda
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kousuke Noda
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akiko Itai
- Institute of Medical Molecular Design Inc, Tokyo, Japan
| | - Kazuya Iwabuchi
- Department of Immunology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Susumu Ishida
- Laboratory of Ocular Cell Biology and Visual Science, Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| |
Collapse
|
18
|
Turan M, Turan G. Overexpression of fractalkine and its histopathological characteristics in primary pterygium. Graefes Arch Clin Exp Ophthalmol 2019; 257:2743-2750. [PMID: 31637486 DOI: 10.1007/s00417-019-04463-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/23/2019] [Accepted: 09/04/2019] [Indexed: 01/09/2023] Open
Abstract
PURPOSE This study aimed to evaluate the differences in the expressions of fractalkine in normal bulbar conjunctiva and primary pterygium tissues. METHODS The study included 48 patients who had been operated on for primary pterygium. Histopathologically, the presence of epithelial atypia, epithelial hyperplasia, goblet cell hyperplasia, epithelial lymphocytic exocytosis, stromal inflammation, mast cell count, and stromal vascularity were evaluated in the primary pterygium tissues. An immunohistochemical fractalkine stain was applied to the primary pterygium tissue samples and normal bulbar conjunctival tissue samples. RESULTS Primary pterygium and normal bulbar conjunctival tissue samples were histopathologically analyzed. Epithelial atypia, epithelial hyperplasia, epithelial lymphocytic exocytosis, stromal inflammation, stromal vascularity, and mast cell count were found to be significantly higher in the primary pterygium (p = 0.001, p = 0.002, p = 0.024, p = 0.007, p = 0.024, and p = 0.013, respectively). When evaluated in terms of fractalkine expression, the epithelial, vascular endothelial, and inflammatory cells were significantly higher in the primary pterygium (p ≤ 0.001, p = 0.002, p = 0.001, respectively). Moreover, compared to the normal bulbar conjunctiva, Ki-67 expression was significantly higher in the primary pterygium tissue samples. CONCLUSION Fractalkine might play a key role in the etiopathogenesis of pterygium. Fractalkine may be important in developing new treatment approaches.
Collapse
Affiliation(s)
- Meydan Turan
- Department of Ophthalmology, Balikesir Ataturk City Hospital, Balikesir, Turkey.
| | - Gulay Turan
- Faculty of Medicine, Department of Pathology, Balikesir University, Balikesir, Turkey
| |
Collapse
|
19
|
A literature review on Fuchs uveitis syndrome: An update. Surv Ophthalmol 2019; 65:133-143. [PMID: 31622627 DOI: 10.1016/j.survophthal.2019.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/14/2022]
Abstract
Fuchs uveitis syndrome is a chronic, typically unilateral, ocular condition characterized by an asymptomatic mild inflammatory syndrome that can result in cataract and secondary glaucoma. Diagnosis is largely clinical because the etiology remains obscure. Fuchs uveitis syndrome is most likely the result of different insults or pathogenic mechanisms, including infections, autoimmune diseases, hereditary and sympathetic dysfunction. According to the infectious theory, the infection of herpes simplex virus, ocular toxoplasmosis, cytomegalovirus, rubella virus, and other viruses have been implicated in the pathogenesis of the disease. There is no indication for corticosteroid therapy in Fuchs patients, and treatment should be mostly reserved to cataract and glaucoma. Phacoemulsification with intraocular lens implantation is a safe procedure with good visual outcomes in patients with Fuchs uveitis syndrome. Glaucoma is often unresponsive to treatment and should actively be monitored both preoperatively and postoperatively in these patients. We discuss the current understanding of Fuchs uveitis syndrome from its clinical presentations through recommended management and provide a comprehensive description and the updated knowledge of its pathophysiology.
Collapse
|
20
|
Russo FY, Ralli M, De Seta D, Mancini P, Lambiase A, Artico M, de Vincentiis M, Greco A. Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms. Immunol Res 2019; 66:675-685. [PMID: 30270399 DOI: 10.1007/s12026-018-9023-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The role of the immune system in mediating cochleovestibular pathologies has received increasing attention in recent years. Autoimmune vertigo may be an invalidating condition and may worsen the quality of life of affected patients, especially in the cases of delayed diagnosis. Since the etiopathogenesis is still not clear, also the treatment is not yet completely delineated. According to the clinical presentation, autoimmune vertigo can present as an isolated disorder or in association with systemic autoimmune diseases. The main feature in autoimmune vertigo is the presence of an abnormal immune response, in either absence or presence of systemic autoimmune disease, directed against delicate components of the inner ear. This may determine a functional or anatomical alteration, with an inflammatory reaction often devastating for hearing and balance. Being the exact pathogenesis unknown, the diagnosis of autoimmune vertigo is based either on clinical criteria or on a positive response to steroids. The earlier the diagnosis is made, the sooner the therapy can be installed, giving a chance to the recovery of inner ear damages. Corticosteroids represent the most effective and universally accepted treatment, even if other immunomodulatory drugs are now having a more extensive use. HIGHLIGHTS: Vertigo is relatively frequent in autoimmune diseases; however, it is often misdiagnosed or attributed to central nervous system alterations rather to specific inner ear involvement. Vertigo and other audiovestibular symptoms may be the first manifestation of an autoimmune disease and if correctly addressed could significantly contribute to early diagnosis of the underlying autoimmune disease. Early diagnosis of immune-related vertigo can lead to prompt initiation of targeted therapy with elevate chances of preventing irreversible damages to the inner ear. The presence of alternating phases of well-being and disabling symptoms in patients with vertigo should always been considered, as they could suggest an underlying autoimmune condition.
Collapse
Affiliation(s)
- Francesca Yoshie Russo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Daniele De Seta
- Department of Oral and Maxillo-facial Surgery, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Marco Artico
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillo-facial Surgery, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100, Rome, Italy
| |
Collapse
|
21
|
Aqueous humor IL-8, IL-10, and VEGF levels in Fuchs' uveitis syndrome and Behçet's uveitis. Int Ophthalmol 2019; 39:2629-2636. [PMID: 31065903 DOI: 10.1007/s10792-019-01112-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 04/30/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE This study investigated the levels of interleukin (IL)-8, IL-10, and vascular endothelial growth factor (VEGF) in the aqueous humor (AqH) of patients with Behçet's uveitis (BU) and Fuchs' uveitis syndrome (FUS) during an inactive period and compared these levels with those in the AqH of noninflammatory healthy control subjects. METHODS This prospective and case-control study included 33 patients (16 patients with BU and 17 patients with FUS) and 35 control subjects. IL-8, IL-10, and VEGF levels in the AqH were quantified by performing sandwich enzyme-linked immunosorbent assay. Kruskal-Wallis test was used to compare the cytokine levels in the different groups, and statistical significance was set at p < 0.05. RESULTS IL-8 levels were significantly higher in the AqH of patients with BU and FUS than in the AqH of control subjects (p < 0.001 and p < 0.001, respectively). IL-10 levels were significantly lower in the AqH of patients with BU than in the AqH of patients with FUS and of control subjects (p = 0.001 and p < 0.001, respectively). Although VEGF levels were higher in the AqH of patients with FUS than in the AqH of patients with BU and of control subjects, the difference was significant only between patients with FUS and control subjects (p < 0.001). CONCLUSIONS We observed a significant decrease in IL-10 levels in the AqH of patients with BU and a significant increase in VEGF levels in the AqH of patients with FUS compared to controls. IL-8 and VEGF levels showed no significant difference among uveitis patients.
Collapse
|
22
|
Pohlmann D, Schlickeiser S, Metzner S, Lenglinger M, Winterhalter S, Pleyer U. Different composition of intraocular immune mediators in Posner-Schlossman-Syndrome and Fuchs' Uveitis. PLoS One 2018; 13:e0199301. [PMID: 29944680 PMCID: PMC6019249 DOI: 10.1371/journal.pone.0199301] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/05/2018] [Indexed: 12/14/2022] Open
Abstract
Posner-Schlossman-Syndrome (PSS) is clinically characterized by acute, recurrent, mild, unilateral uveitis anterior accompanied by elevated intraocular pressure (IOP). Fuchs´ Uveitis (FU) is a chronic, low-grade-inflammatory disorder, involving anterior uvea and vitreous. The clinical findings show remarkable similarities as well as differences. In our study, we determine the composition of immune mediators in aqueous humor of patients with PSS and FU and evaluate if immune mediators play a crucial role in specific viral intraocular inflammation and IOP rises. Aqueous humor samples from 81 uveitis patients (= eyes) presenting with either PSS or FU were collected at one time point. Local intraocular antibody synthesis to rubella virus was confirmed in 65 patients, whereas 16 were tested positively for human cytomegalovirus. Thirteen patients with PSS and 10 patients with FU were treated with glaucoma medications. Additionally, 11 cataract patients acted as control group. Immune mediator concentrations were measured by Bio-Plex Pro assay. We observed in both PSS (IFN-γ: 174.9 pg/mL; TNF-α: 25.1 pg/mL) and FU (IFN-γ: 25.4 pg/mL; TNF-α: 27.2 pg/mL) groups a significantly increased level of T-helper 1 immune mediators compared to controls (IFN-γ, TNF-α: 0 pg/mL) [median]. Notably, PSS patients (IL-1RA: 73.4 pg/mL; IL-8: 199.4 pg/mL; IL-10: 33.4 pg/mL; IP-10: 126350 pg/mL) showed a stronger and more active ocular inflammatory response, than FU patients (IL-1RA: 4.3 pg/mL; IL-8: 72.4 pg/mL; IL-10: 1.6 pg/mL; IP-10: 57400 pg/mL). Furthermore, a negative correlation between mediators and IOP was seen in the PSS group, potentially caused by acetazolamide-treatment. Our findings show that immune mediators play a crucial role in specific viral intraocular inflammation and influence IOP levels. Remarkable similarities but also significant differences of immune mediator concentrations are apparent in PSS compared to FU. High concentrations of IL-1RA, IL-8, IL-10, and IP-10 correlate with active inflammation in PSS, while FU may trigger chronic inflammation. Our data also substantiated a very similar composition of cytokines in those patients from the PSS group suffering from ocular hypertension and thus offers a potential explanation model for a negative correlation between mediators and IOP.
Collapse
Affiliation(s)
- Dominika Pohlmann
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- * E-mail:
| | - Stephan Schlickeiser
- Institute of Medical Immunology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Sylvia Metzner
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Matthias Lenglinger
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sibylle Winterhalter
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Uwe Pleyer
- Department of Ophthalmology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
23
|
Liu B, Deng T, Zhu L, Zhong J. Association of human leukocyte antigen (HLA)-DQ and HLA-DQA1/DQB1 alleles with Vogt-Koyanagi-Harada disease: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e9914. [PMID: 29443768 PMCID: PMC5839848 DOI: 10.1097/md.0000000000009914] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the association of human leukocyte antigen (HLA)-DQ and HLA-DQA1/DQB1 alleles with Vogt-Koyanagi-Harada (VKH), providing further evidences on the genetic background of this disease. METHODS A comprehensive literature search was conducted on the relationship of HLA-DQ and/or HLA-DQA1/DQB1 alleles with VKH through PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and databases for grey literature. The last search was in October 2017. Pooled odds ratio (OR) with 95% confidence interval (95% CI) was calculated from extracted data to access the strength of the association between a genotype and VKH. RESULTS HLA-DQ4 was confirmed to increase the risk of VKH significantly (OR = 4.63, 95% CI: 1.74-12.31, P = .002), while HLA-DQ1 seemed to reduce VKH occurrence with OR = 0.32 (95% CI: 0.22-0.47, P < .00001). HLA-DQA1*0301-(OR = 4.52, 95% CI: 1.42-14.35, P = .01) and HLA-DQB1*0401-(OR = 23.12, 95% CI: 11.54-46.31, P < .00001) positive patients probably had a rising tendency to suffer from VKH. Alleles including HLA-DQA1*0103, 0401, 0501 and HLA-DQB1*0301, 0402, 0601, 0603 were significant protective genetic factors. CONCLUSION We concluded that HLA-DQ4 carriers had a higher risk of VKH and HLA-DQ1 seemed to be protective. People with positive HLA-DQA1*0301 and HLA-DQB1*0401 demonstrated to be more susceptible to VKH. HLA-DQA1*0103, 0401, 0501 and HLA-DQB1*0301, 0402, 0601, 0603 could be potential protectors.
Collapse
Affiliation(s)
- Bing Liu
- Department of Ophthalmology, the First Affiliated Hospital of Jinan University
| | - Tuo Deng
- Department of Urology, Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Urology, Guangdong Key Laboratory of Urology, Guangzhou, China
| | - Linxin Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Jinan University
| | - Jingxiang Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Jinan University
| |
Collapse
|
24
|
Fazil Z, Ten Berge JC, Langerak AW, Rothova A, Dik WA. An Intraocular Inflammatory Profile of Rubella Associated Uveitis. Ocul Immunol Inflamm 2018; 27:418-423. [DOI: 10.1080/09273948.2017.1421671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Z. Fazil
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J. C. Ten Berge
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - A. W. Langerak
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - A. Rothova
- Department of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - W. A. Dik
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
25
|
Serum Profiles of Cytokines in Behcet's Disease. J Clin Med 2017; 6:jcm6050049. [PMID: 28468317 PMCID: PMC5447940 DOI: 10.3390/jcm6050049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/14/2017] [Accepted: 04/17/2017] [Indexed: 02/03/2023] Open
Abstract
Introduction: Behcet’s disease (BD) is a chronic systemic autoinflammatory vasculitis which is handled by the variety of proteins like cytokines. Therefore, cytokines are considered as one of the prototypic factors during inflammatory responses of BD. Consequently, the present study was designed for evaluation of cytokine profiles in Iranian BD cases, including those with and without uveitis. Materials and Method: All cases were divided into three groups based on ophthalmologic exam results: BD with uveitis, BD without uveitis, and recovered uveitis BD. Cases with a history of BD recovery were placed in the group of recovered uveitis. The patients with infectious uveitis as well as other collagen vascular diseases and patients who have used biologics to treat ocular immune-mediated diseases were excluded. Finally, after venous blood sampling, levels of cytokines were quantified and statistical approaches were performed for measurements. Results: Enrolled cases were divided to 26 patients with active uveitis, 25 patients with recovered uveitis and 24 patients without uveitis and interestingly, just IL-2 was the only cytokine that showed statistical difference in patients with BD uveitis in comparison with other groups (pvalue = 0.02). The pair wise comparison showed a significant difference between the patients with and without uveitis groups (pvalue = 0.004) as well as patients with uveitis and recovered uveitis groups (pvalue = 0.002). Discussion: Significant elevation of IL-2 in patients with uveitis (in comparison with recovered or without uveitis cases) demonstrates that it may be one of the main proteins that enroll in the pathophysiology of BD uveitis and may be considered as a new target for refractory disease therapies. Studies with larger samples can help to obtain more accurate conclusions.
Collapse
|
26
|
Wakefield D, Yates W, Amjadi S, McCluskey P. HLA-B27 Anterior Uveitis: Immunology and Immunopathology. Ocul Immunol Inflamm 2016; 24:450-9. [PMID: 27245590 DOI: 10.3109/09273948.2016.1158283] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Acute anterior uveitis (AAU) is the commonest type of uveitis and HLA-B27 AAU is the most frequently recognized type of acute anterior uveitis and anterior uveitis overall. Recent evidence indicates that acute anterior uveitis is a heterogenous disease, is polygenic and is frequently associated with the spondyloarthropathies (SpA). Studies of patients with AAU and animal models of disease indicate a role for innate immunity, the IL-23 cytokine pathway and exogenous factors, in the pathogenesis of both SpA and acute anterior uveitis. Recently described genetic associations cluster around immunologic pathways, including the IL-17 and IL-23 pathways, antigen processing and presentation, and lymphocyte development and activation. Patients with ankylosing spondylitis (AS) and AAU share other genetic markers, such as ERAP-1, which show strong evidence of gene-gene interaction and point to new mechanisms of disease pathogenesis. These observations have major implications for understanding the pathogenesis of HLA-B27 diseases, such as AAU, and may lead to the development of more specific therapy for AAU. Received 6 January 2016; revised 6 February 2016; accepted 18 February 2016; published online 31 May 2016.
Collapse
Affiliation(s)
- Denis Wakefield
- a Laboratory of Ocular Immunology , University of New South Wales , Kensington , Sydney , Australia
| | - William Yates
- a Laboratory of Ocular Immunology , University of New South Wales , Kensington , Sydney , Australia
| | - Shahriar Amjadi
- a Laboratory of Ocular Immunology , University of New South Wales , Kensington , Sydney , Australia
| | - Peter McCluskey
- b Save Sight Institute, Discipline of Ophthalmology , Sydney Medical School, The University of Sydney , Sydney , Australia
| |
Collapse
|
27
|
Pichi F, Carrai P, Srivastava SK, Lowder CY, Nucci P, Neri P. Genetic of uveitis. Int Ophthalmol 2015; 36:419-33. [PMID: 26453112 DOI: 10.1007/s10792-015-0136-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/04/2015] [Indexed: 12/11/2022]
Abstract
Immune-mediated uveitis may be associated with a systemic disease or may be localized to the eye. T-cell-dependent immunological events are increasingly being regarded as extremely important in the pathogenesis of uveitis. Several studies have also shown that macrophages are major effectors of tissue damage in uveitis. Uveitis phenotypes can differ substantially, and most uveitis diseases are considered polygenic with complex inheritance patterns. This review attempts to present the current state of knowledge from in vitro and in vivo research on the role of genetics in the development and clinical course of uveitis. A review of the literature in the PubMed, MEDLINE, and Cochrane databases was conducted to identify clinical trials, comparative studies, case series, and case reports describing host genetic factors as well as immune imbalance which contribute to the development of uveitis. The search was limited to primary reports published in English with human subjects from 1990 to the present, yielding 3590 manuscripts. In addition, referenced articles from the initial searches were hand searched to identify additional relevant reports. After title and abstract selection, duplicate elimination, and manual search, 55 papers were selected for analysis and reviewed by the authors for inclusion in this review. Studies have demonstrated associations between various genetic factors and the development and clinical course of intraocular inflammatory conditions. Genes involved included genes expressing interleukins, chemokines, chemokine receptors, and tumor necrosis factor and genes involved in complement system. When considering the genetics of uveitis, common threads can be identified. Genome-wide scans and other genetic methods are becoming increasingly successful in identifying genetic loci and candidate genes in many inflammatory disorders that have a uveitic component. It will be important to test these findings as uveitis-specific genetic factors. Therefore, the burgeoning understanding of the human genome promises to result in new insight into the pathogenesis of uveitis.
Collapse
Affiliation(s)
- Francesco Pichi
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
- San Giuseppe Hospital, University Eye Clinic, via San Vittore 12, 20123, Milan, Italy.
| | - Paola Carrai
- San Giuseppe Hospital, University Eye Clinic, via San Vittore 12, 20123, Milan, Italy
| | | | | | - Paolo Nucci
- San Giuseppe Hospital, University Eye Clinic, via San Vittore 12, 20123, Milan, Italy
| | - Piergiorgio Neri
- The Ocular Immunology Service, The Eye Clinic, Università Politecnica dele Marche, Ancona, Italy
| |
Collapse
|
28
|
Abstract
PURPOSE Rubella virus (RV) has a central role in the etiopathogenesis of Fuchs' uveitis syndrome (FUS). We aim to offer new insights by comprehensive analysis of recent laboratory and epidemiologic data. METHODS We conducted a literature search for laboratory data and papers on etiopathogenesis. RESULTS Aqueous humour samples of FUS patients show immunoreactivity to RV, in a specific and sensitive manner. Identification of RV genome confirm intraocular infection in a subset of FUS patients. Epidemiologic findings further support causality. The clinical spectrum of RV-associated uveitis is similar but not identical to FUS. FUS eyes exhibit a predominance of CD8 + T cells, high IFN-? and IL-10 levels. CONCLUSIONS RV is the leading cause of FUS. Cytokine-based findings mirror a viral etiology and chronic low-grade inflammation. RV-associated FUS represents a common pathway of intraocular RV inoculation after congenital or acquired infection. Other causes, including HSV and CMV, may lead to FUS.
Collapse
Affiliation(s)
| | - Thierry Derveaux
- a University Hospital Ghent , Ophthalmology , Ghent , Belgium and
| | | | | |
Collapse
|
29
|
Intraocular levels of interleukin 17A (IL-17A) and IL-10 as respective determinant markers of toxoplasmosis and viral uveitis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 22:72-8. [PMID: 25378353 DOI: 10.1128/cvi.00423-14] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Uveitis is a potentially blinding inflammatory disease. Thirty to 50% of uveitis cases are considered idiopathic. The present study sought to determine the intraocular cytokine patterns in the different etiological types of uveitis in order to better understand their immunological regulation and to determine whether the cytokine pattern may be a useful diagnostic tool. From a multicenter institutional prospective study, the clinical and biological data from patients with uveitis of various etiologies, determined after a complete workup, were compared with those from a control group of cataract patients. A multiplex assay was used to assess the profiles of 27 cytokines and chemokines in aqueous humor samples from these patients. In total, 62 patients with infectious or noninfectious uveitis and 88 controls were included. After a complete workup, the cause of uveitis remained unknown in 25 patients (40% idiopathic uveitis). Interleukin 1β (IL-1β) levels were markedly increased in viral uveitis, as were IL-10 levels, whereas IL-17A levels were augmented in toxoplasmic uveitis. Based on the cytokine pattern, the patients were reassigned to specific groups. At the end of the study, the diagnosis of idiopathic uveitis was still valid in only 11 patients (18%). The observation that some markers are specific to certain diseases enables a better understanding of the disease pathogenesis and paves the way for new diagnostic methods aimed to identify inflammatory markers, which may perhaps be targeted by therapy.
Collapse
|
30
|
Ng JY, Luk FO, Lai TY, Pang CP. Influence of molecular genetics in Vogt-Koyanagi-Harada disease. J Ophthalmic Inflamm Infect 2014; 4:20. [PMID: 25097674 PMCID: PMC4105881 DOI: 10.1186/s12348-014-0020-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 07/08/2014] [Indexed: 01/13/2023] Open
Abstract
Vogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune disorder against melanocytes. Recent studies have identified multiple genetic factors that might be associated with the pathogenesis of VKH disease. We performed an electronic database search of PubMed, MEDLINE, and EMBASE, and all relevant papers published up to 13 June 2014 were reviewed. A total of 1,031 publications including articles relevant to the genetics of VKH disease and the references of these articles were reviewed. The review identified a number of genetic factors which might be involved in the pathogenesis of VKH disease, some of which may alter the clinical course of VKH disease. Genes which might be involved in the pathogenesis of VKH disease included genes expressing HLA, complement factor H, interleukins, cytotoxic T-lymphocyte antigen 4 (CTLA-4), killer cell immunoglobulin-like receptors (KIR), programmed cell death 1 (PDCD1), protein tyrosine phosphatase non-receptor 22 (PTPN22), osteopontin, tumor necrosis factor alpha-induced protein 3 (TNFAIP3), macrophage migration inhibitory factor (MIF), and other immune response genes. Further studies to explore the correlation among different genotypes and phenotypes of VKH disease will be useful to shed light on the pathogenesis of uveitis in VKH disease and may facilitate the development of new treatment modalities of uveitis in VKH disease.
Collapse
Affiliation(s)
- Joanne Yw Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Kowloon ᅟ, Hong Kong
| | - Fiona Oj Luk
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Kowloon ᅟ, Hong Kong
| | - Timothy Yy Lai
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Kowloon ᅟ, Hong Kong
| | - Chi-Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Kowloon ᅟ, Hong Kong
| |
Collapse
|
31
|
de-la-Torre A, Pfaff AW, Grigg ME, Villard O, Candolfi E, Gomez-Marin JE. Ocular cytokinome is linked to clinical characteristics in ocular toxoplasmosis. Cytokine 2014; 68:23-31. [PMID: 24787053 PMCID: PMC4889015 DOI: 10.1016/j.cyto.2014.03.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/16/2014] [Accepted: 03/23/2014] [Indexed: 01/01/2023]
Abstract
PURPOSE To determine the cytokine levels in aqueous humor (AH) of Colombian patients with active ocular toxoplasmosis (OT), and to correlate them with their clinical characteristics. METHODS 27 Cytokines/chemokines were assayed in 15 AH samples (nine patients with diagnosis of OT biologically-confirmed and six controls that underwent cataract surgery). Correlations were assessed between cytokine/chemokine levels, type of inflammatory response (Th1, Th2, Th17, Treg), and clinical characteristics. RESULTS Th2 predominant response was related to more severe clinical features. The presence of VEGF and IL-5 was related to higher number of recurrences. Growth factors (VEGF, FGF, PDGF-β), were related to higher number of lesions. Patients infected by type-I/III strains had a particular intraocular cytokine-pattern. CONCLUSIONS Th2 response was related to more severe clinical characteristics in patients infected by Type I/III strains. IL-5 and VEGF were associated with recurrences. We correlate for the first time, specific cytokine-patterns with clinical characteristics and with the infecting Toxoplasma strain.
Collapse
Affiliation(s)
- Alejandra de-la-Torre
- Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Departamento de Inmunología, Bogotá, Colombia
| | - Alexander W Pfaff
- Institut de Parasitologie et Pathologie Tropicale, Fédération de Médecine Translationelle de Strasbourg, Université de Strasbourg, France
| | - Michael E Grigg
- Laboratory of Parasitic Diseases, National Institutes of Health, National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD, USA
| | - Odile Villard
- Institut de Parasitologie et Pathologie Tropicale, Fédération de Médecine Translationelle de Strasbourg, Université de Strasbourg, France
| | - Ermanno Candolfi
- Institut de Parasitologie et Pathologie Tropicale, Fédération de Médecine Translationelle de Strasbourg, Université de Strasbourg, France
| | - Jorge E Gomez-Marin
- GEPAMOL, Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindío, Avenida Bolivar 12N, Armenia, Colombia.
| |
Collapse
|
32
|
Phatak S, Agrawal R, Pavesio C. Adalimumab: viable treatment option for pediatric refractory uveitis? EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/17469899.2014.903801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
33
|
Abstract
BACKGROUND Uveitis is a diverse group of intraocular inflammatory disease and is a significant cause of visual loss worldwide. Recent studies have identified various endogenous immune mechanisms and genetic factors that are involved in the pathogenesis of uveitis. This review provides an overview on the role of genetics in the development and clinical course of uveitis. METHODS PUBMED was used for literature search, and articles published from 1970 to 2012 that evaluated the genetic associations and mechanisms involved in the development and clinical features of uveitis were included. RESULTS Studies have demonstrated associations between various genetic factors and the development and clinical course of intraocular inflammatory conditions. Genes involved included genes expressing interleukins, chemokines, chemokine receptors, and tumor necrosis factor and genes involved in complement system, oxidation, and other intracellular molecular pathways. CONCLUSION Multiple genetic factors play important roles in the pathogenesis of uveitis and may influence the clinical course of uveitis. Further studies to investigate the genetic mechanisms of uveitis might identify additional genetic associations and might have the potential for identifying novel therapeutic targets in the treatment of intraocular inflammation.
Collapse
|
34
|
Reiff A, Kadayifcilar S, Özen S. Rheumatic Inflammatory Eye Diseases of Childhood. Rheum Dis Clin North Am 2013; 39:801-32. [DOI: 10.1016/j.rdc.2013.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
35
|
Nahdi I, Abdelwahed RB, Boukoum H, Bressollette-Bodin C, Attia S, Yahia SB, Fisson S, Khairallah M, Aouni M. Herpesvirus detection and cytokine levels (IL-10, IL-6, and IFN-γ) in ocular fluid from Tunisian immunocompetent patients with uveitis. J Med Virol 2013; 85:2079-86. [DOI: 10.1002/jmv.23708] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Imen Nahdi
- Laboratory of Contagious Diseases and Biologically Active Substances, LR99-ES27; Faculty of Pharmacy, Monastir University; Monastir Tunisia
| | - Rym Ben Abdelwahed
- Laboratory of Contagious Diseases and Biologically Active Substances, LR99-ES27; Faculty of Pharmacy, Monastir University; Monastir Tunisia
- National Institute of the Health and the Medical Research (INSERM), UMRS 872; Research Center of the Cordeliers, Pierre et Marie Curie-Paris 6 University; Paris France
| | - Hannen Boukoum
- Laboratory of Contagious Diseases and Biologically Active Substances, LR99-ES27; Faculty of Pharmacy, Monastir University; Monastir Tunisia
| | | | - Sonia Attia
- Ophthalmology Department; Fattouma Bourguiba University Hospital; Tunisia
| | - Salim Ben Yahia
- Ophthalmology Department; Fattouma Bourguiba University Hospital; Tunisia
| | - Sylvain Fisson
- National Institute of the Health and the Medical Research (INSERM), UMRS 872; Research Center of the Cordeliers, Pierre et Marie Curie-Paris 6 University; Paris France
- Genethon, UMRS 951; University of Evry Val d'Essonne; Evry France
| | - Moncef Khairallah
- Ophthalmology Department; Fattouma Bourguiba University Hospital; Tunisia
| | - Mahjoub Aouni
- Laboratory of Contagious Diseases and Biologically Active Substances, LR99-ES27; Faculty of Pharmacy, Monastir University; Monastir Tunisia
| |
Collapse
|
36
|
Jeon S, Lee WK, Jung Y. Changes in the Intraocular Cytokine Levels after Intravitreal Bevacizumab in Uveitic Macular Edema. Ocul Immunol Inflamm 2012; 20:360-4. [DOI: 10.3109/09273948.2012.709576] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
37
|
Li J, Ang M, Cheung CMG, Vania M, Chan ASY, Waduthantri S, Yang H, Chee SP. Aqueous cytokine changes associated with Posner-Schlossman syndrome with and without human cytomegalovirus. PLoS One 2012; 7:e44453. [PMID: 23028541 PMCID: PMC3441587 DOI: 10.1371/journal.pone.0044453] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/03/2012] [Indexed: 12/14/2022] Open
Abstract
AIM To study the differences in aqueous cytokines in Posner-Schlossman Syndrome (PSS) patients with and without human cytomegalovirus (CMV) DNA in the aqueous humor. METHODS This is a prospective study. Fifty-three uveitis patients with clinical signs of PSS were enrolled and aqueous humor samples were collected. Fourteen PSS patients were positive of CMV DNA in the aqueous by polymerase chain reaction (PCR) analysis. These eyes were negative of common ocular pathogens such as herpes simplex virus, varicella-zoster virus, rubella virus and toxoplasma. Twenty-five otherwise healthy cataract patients were enrolled as controls. Cytokine concentration was measured by a magnetic color-bead-based multiplex assay and analyzed using statistical and classification approaches. RESULTS The average age of 53 PSS patients was 48.74±13.43 years (yrs) (mean ± standard deviation) and 66.3±15.0 yrs for the controls. The median CMV viral DNA copy number was 26000/mL aqueous (range 1400 to 85000 copies/mL) in 14 CMV positive patients as determined by quantitative PCR. PSS aqueous had significantly higher Interleukin (IL)-8 (CXCL8), monocyte chemotactic protein-1 (CCL2), macrophage inhibitory protein 1-β (CCL4), granulocyte colony-stimulating factor (GCSF) and transforming growth factor-β (TGF-β) levels than controls after adjusted by age and gender. IL-2, IL-12, tumor necrosis factor-α (TNF-α) and interferon-α (IFN-α) levels were significantly lower in PSS aqueous than controls. No difference between CMV positive PSS and CMV negative PSS aqueous was observed. Over 97% of PSS samples were distinguished from controls by elevated CXCL10 (>500 ng/mL), CXCL8 (>30 ng/mL) and CCL2 (>60 ng/mL) levels. CONCLUSION PSS eyes were characterized by elevated aqueous chemokine concentration. The presence of CMV viral DNA was not associated with significant change of the type of cytokine expression in PSS patients.
Collapse
Affiliation(s)
- Jing Li
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Ocular Inflammation Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Marcus Ang
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Ocular Inflammation and Immunology Services, Singapore National Eye Centre, Singapore, Singapore
| | - Chui Ming Gemmy Cheung
- Ocular Inflammation and Immunology Services, Singapore National Eye Centre, Singapore, Singapore
| | - Maya Vania
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Anita Sook Yee Chan
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Ocular Inflammation and Immunology Services, Singapore National Eye Centre, Singapore, Singapore
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Samanthila Waduthantri
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Ocular Inflammation and Immunology Services, Singapore National Eye Centre, Singapore, Singapore
| | - Henry Yang
- Cancer Science Institute of Singapore, Singapore, Singapore
| | - Soon Phaik Chee
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Ocular Inflammation and Immunology Services, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- * E-mail:
| |
Collapse
|
38
|
Sukumaran S, Marzan K, Shaham B, Reiff A. High dose infliximab in the treatment of refractory uveitis: does dose matter? ISRN RHEUMATOLOGY 2012; 2012:765380. [PMID: 22389806 PMCID: PMC3263752 DOI: 10.5402/2012/765380] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 10/03/2011] [Indexed: 12/14/2022]
Abstract
Background. Infliximab (INF) has been shown to be beneficial in treating refractory uveitis, however, no data exist on optimal dosing and the efficacy of higher dosing. Objectives. To compare the efficacy of low-dose (LD) (<10 mg/kg), moderate-dose (MD) (≥10–15 mg/kg), and high-dose (HD) INF (≥15–20 mg/kg) in the treatment of uveitis. Methods. Retrospective chart review children with uveitis diagnosed at Childrens Hospital Los Angeles and Millers Children's Hospital, CA, USA. Results. Of the 34 INF-treated children, 6 patients received LD, 19 received MD, and 9 received HD. Average disease duration prior to therapy was 10.6, 24.6, and 37.1 months each group, respectively. Topical steroids were discontinued after an average of 3 months, 9.5 months, and 10.2 months in the LD, MD, and HD groups, respectively. We found that 66% of patients receiving LD, 42% of MD, and 66% receiving HD INF failed therapy and required either dose escalation or alternate medication for disease control. Conclusions. INF is beneficial in the treatment of uveitis, and dose escalation up to 4 times above the approved dose is often necessary to achieve disease control in patients with uveitis. Doses < 10 mg/kg every 4 weeks may not be sufficient to control disease.
Collapse
Affiliation(s)
- Sukesh Sukumaran
- Division of Pediatric Rheumatology, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | | | | | | |
Collapse
|
39
|
Abstract
Autoimmune uveitis is a complex group of sight-threatening diseases that arise without a known infectious trigger. The disorder is often associated with immunological responses to retinal proteins. Experimental models of autoimmune uveitis targeting retinal proteins have led to a better understanding of the basic immunological mechanisms involved in the pathogenesis of uveitis and have provided a template for the development of novel therapies. The disease in humans is believed to be T cell-dependent, as clinical uveitis is ameliorated by T cell-targeting therapies. The roles of T helper 1 (Th1) and Th17 cells have been major topics of interest in the past decade. Studies in uveitis patients and experiments in animal models have revealed that Th1 and Th17 cells can both be pathogenic effectors, although, paradoxically, some cytokines produced by these subsets can also be protective, depending on when and where they are produced. The major proinflammatory as well as regulatory cytokines in uveitis, the therapeutic approaches, and benefits of targeting these cytokines will be discussed in this review.
Collapse
Affiliation(s)
- Reiko Horai
- Laboratory of Immunology, National Eye Institute, National Institute of Health, Bethesda, Maryland 20892-1857, USA
| | | |
Collapse
|
40
|
Induction of indoleamine 2,3-dioxygenase by interferon-gamma in human lens epithelial cells: apoptosis through the formation of 3-hydroxykynurenine. Int J Biochem Cell Biol 2010; 42:1446-54. [PMID: 20435158 DOI: 10.1016/j.biocel.2010.04.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 04/15/2010] [Accepted: 04/22/2010] [Indexed: 12/30/2022]
Abstract
Interferon-gamma (IFN-gamma) is known to cause apoptosis of lens epithelial cells and cataract formation, but the molecular mechanisms underlying these effects are unknown. IFN-gamma induces the expression of indoleamine 2,3-dioxygenase (IDO) and thereby enhances the production of kynurenines from l-tryptophan. The present study was designed to investigate the role of IDO and kynurenines in the IFN-gamma-mediated apoptosis of lens epithelial cells and to determine the signaling pathways involved. IFN-gamma stimulated the synthesis of IDO and activated the JAK-STAT1 signaling pathway in human lens epithelial cells (HLE-B3) in a dose-dependent manner. Meanwhile, fludarabine, an inhibitor of STAT1 activation, blocked IFN-gamma-mediated IDO expression. N-Formylkynurenine, kynurenine (Kyn) and 3-hydroxykynurenine (3OHKyn) were detected in cells, with 3OHKyn concentrations being higher than those of the other kynurenines. The intracellular production of kynurenines was completely blocked by 1-methyl-DL-tryptophan (MT), an inhibitor of IDO. Kyn- and 3OHKyn-modified proteins were detected in IFN-gamma-treated cells. The induction of IDO by IFN-gamma in HLE-B3 cells caused increases in intracellular ROS, cytosolic cytochrome c and caspase-3 activity, along with a decrease in protein-free thiol content. These changes were accompanied by apoptosis. At equimolar concentrations, 3OHKyn caused higher levels of apoptosis than the other kynurenines in HLE-B3 cells. MT and a kynurenine 3-hydroxylase inhibitor (Ro61-8048) effectively inhibited IFN-gamma-mediated apoptosis in HLE-B3 cells. Our results show that the induction of IDO by IFN-gamma is JAK-STAT1 pathway-dependent and that this induction causes 3OHKyn-mediated apoptosis in HLE-B3 cells. These data suggest that IDO-mediated kynurenine formation could play a role in cataract formation related to chronic inflammation.
Collapse
|
41
|
Abstract
Pediatric non-infectious uveitis remains a rare but potentially sight-threatening group of diseases. However, early screening and treatment can improve outcomes. No single agent has proven to be efficacious in all cases. A wide variety of long-term immunomodulatory treatments are available; these agents differ in both their potency and side effect profiles. Corticosteroids remain an extremely valuable form of treatment in the short-term management of uveitis. Other major groups of immunomodulatory treatments include the calcineurin inhibitors and antimetabolites such as methotrexate, which is frequently used as the first-line agent. The biologics, including anti-tumor necrosis factor agents and interferons, are newer and potentially very useful therapies although side effects limit their use. Successful outcomes may be achieved with appropriate immunosuppressant therapy given early in the disease, although clinical trials are required to define the true efficacy of this strategy.
Collapse
|
42
|
Kohno H, Sakai T, Tsuneoka H, Imanishi K, Saito S. Staphylococcal enterotoxin B is involved in aggravation and recurrence of murine experimental autoimmune uveoretinitis via Vbeta8+CD4+ T cells. Exp Eye Res 2009; 89:486-93. [PMID: 19523946 DOI: 10.1016/j.exer.2009.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 04/25/2009] [Accepted: 05/11/2009] [Indexed: 10/20/2022]
Abstract
Endogenous uveitis is a common cause of visual disability and blindness. The etiology of uveitis remains largely unknown but reasonable etiologic factors include infections. Superantigens are regarded as one of the leading causes of infectious etiology in autoimmune disease. However, the role of superantigens in uveitis remains unclear. In the present study, we investigated the effect of Staphylococcal enterotoxin B (SEB), a member of the superantigens, using an experimental model of autoimmune uveoretinitis (EAU). C57BL/6 mice were immunized with human interphotoreceptor retinoid binding protein (IRBP) peptide, and the severity of EAU disease was scored. Vehicle (PBS) alone or SEB dissolved in PBS was administered by intravenous injection on post-immunization day 10 or on post-immunization day 24. In addition, a systemic immune response study was performed to address the effects of SEB on systemic immunity. EAU was aggravated significantly by the injection of SEB at post-immunization day 10. Furthermore, relapse was induced by the injection of SEB at day 24. On the other hand, SEB injection without IRBP peptide immunization elicited no inflammatory changes in the uvea or retina. Furthermore, SEB enhanced not only the IRBP-specific T-cell proliferative responses but also IFN-gamma and IL-17 production. Moreover, the intraocular expression levels of these cytokines was also enhanced by SEB injection. Both anti-CD4 and -Vbeta8 Ab administration suppressed disease aggravation and the enhancement of IRBP-specific T-cell responses caused by SEB. These results suggest that SEB is involved significantly in the aggravation or recurrence of endogenous uveitis through activation of autoreactive uveitogenic T cells.
Collapse
Affiliation(s)
- Hideo Kohno
- Department of Ophthalmology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | | | | | | | | |
Collapse
|
43
|
Indoleamine 2,3-dioxygenase overexpression causes kynurenine-modification of proteins, fiber cell apoptosis and cataract formation in the mouse lens. J Transl Med 2009; 89:498-512. [PMID: 19308046 PMCID: PMC2722445 DOI: 10.1038/labinvest.2009.22] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Indoleamine 2,3-dioxygenase (IDO) is the first enzyme in the kynurenine pathway. The kynurenines formed in this pathway chemically modify proteins and cause apoptosis in cells. Evidence suggests that kynurenines and their protein modifications are involved in cataract formation, but this has yet to be directly demonstrated. We generated transgenic (Tg) mouse lines that overexpress human IDO in the lens. Homozygous Tg (homTg) lenses had higher IDO immunoreactivity, approximately 4.5 times greater IDO mRNA, and approximately 8 times higher IDO activity compared to lenses from hemizygous Tg (hemTg) animals. The kynurenine content was threefold higher in homTg than in hemTg but was not detected in wild-type (Wt) lenses. Kynurenine modifications were approximately 2.6 times greater in homTg than in hemTg or Wt. HomTg lenses had vacuoles in the epithelium and cortical fiber cells. Kynurenine modifications coincided with apoptosis in the secondary fiber cells of homTg lenses. Caspase-3 and caspase-9 activities were markedly higher in homTg than in hemTg and Wt. The glutathione content was approximately 36% lower in homTg compared to hemTg and Wt lenses. HomTg animals also developed bilateral cataracts within 3 months of birth. Together these data demonstrate that IDO-mediated production of kynurenines results in defects in fiber cell differentiation and their apoptosis and suggest that IDO activity is kept low in the lens to prevent deleterious effects by kynurenines.
Collapse
|
44
|
CONCENTRATION OF CYTOKINES IN THE AQUEOUS HUMOR OF PATIENTS WITH NAIVE, RECURRENT AND REGRESSED CNV ASSOCIATED WITH AMD AFTER BEVACIZUMAB TREATMENT. Retina 2009; 29:523-9. [DOI: 10.1097/iae.0b013e318195cb15] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
45
|
Diaz-Llopis M, García-Delpech S, Salom D, Udaondo P, Hernández-Garfella M, Bosch-Morell F, Quijada A, Romero FJ. Adalimumab therapy for refractory uveitis: a pilot study. J Ocul Pharmacol Ther 2008; 24:351-61. [PMID: 18476805 DOI: 10.1089/jop.2007.0104] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The aim of this study was to assess the efficacy and safety of adalimumab in treating refractory autoimmune uveitis. METHODS This work was a prospective, noncomparative, nonrandomized, clinical trial. Nineteen (19) patients meeting eligibility criteria received a 40-mg subcutaneous (s.c.) injection of adalimumab every other week during 1 year. RESULTS All patients underwent an outcome assessment at month 12. Visual acuity improved by -0.3 logMar in 12 (31%) eyes of 38, and worsened by +0.3 logMar in 1 (2.6%) eye. All patients had an active intraocular inflammation at baseline, and 12 patients (63%) achieved control of their inflammation with adalimumab at the end of follow-up. After optic coherence tomography, 33 eyes (86%) had cystoid macular edema (CME) at baseline, and at the end of follow-up there was a complete resolution of CME in 18 of these 33 eyes (54.54%). All patients were able to reduce at least 50% of the dose of the concomitant immunosuppressive drugs at the end of follow-up. Adalimumab was well tolerated in all patients, and only local minor side effects at the s.c. injection site were observed. Nevertheless, 8 patients (42.10%) had relapses during the follow-up period that were controlled with 1 periocular steroid injection. CONCLUSIONS Adalimumab seems to be an effective, safe therapy for the management of refractory uveitis and may provide the possibility to reduce the concomitant immunosuppressive drugs in these patients. Further long-term studies are warranted to determine the safety and efficacy of adalimumab in treating intraocular inflammation.
Collapse
Affiliation(s)
- Manuel Diaz-Llopis
- Uveitis and Retina Unit, Department of Ophthalmology, University General Hospital of Valencia, Valencia, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Kramer M, Monselise Y, Bahar I, Cohen Y, Weinberger D, Goldenberg-Cohen N. Serum cytokine levels in active uveitis and remission. Curr Eye Res 2007; 32:669-75. [PMID: 17852191 DOI: 10.1080/02713680701523147] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Serum levels of interleukin(IL)-8, IL-6, and (TNF)-alpha were measured in 25 patients during active uveitis and uveitis in remission and compared to age-matched controls. Levels of IL-8 and IL-6 were significantly elevated in patients with active disease and were decreased during remission. IL-8 levels were highest in patients with anterior uveitis, with greatest difference between active disease and remission. No consistent pattern was observed for TNF-alpha. In conclusion, serum cytokine levels are elevated in active noninfectious uveitis. The rise in IL-8 may suggest innate immune mechanisms in the acute disease, while IL-6 participates in modulation of inflammation in the chronic disease.
Collapse
Affiliation(s)
- M Kramer
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
| | | | | | | | | | | |
Collapse
|
47
|
Sijssens KM, Rijkers GT, Rothova A, Stilma JS, Schellekens PAWJF, de Boer JH. Cytokines, chemokines and soluble adhesion molecules in aqueous humor of children with uveitis. Exp Eye Res 2007; 85:443-9. [PMID: 17662277 DOI: 10.1016/j.exer.2007.06.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Revised: 06/06/2007] [Accepted: 06/10/2007] [Indexed: 12/19/2022]
Abstract
Uveitis in childhood is a visual threatening disease with a complication rate of more than 75%. Despite extensive research, the etiology of uveitis is still unclear although the general opinion is now that uveitis is a T-cell mediated disease. The purpose of this study was to investigate the profile of cytokines, chemotactic cytokines (chemokines) and soluble adhesion molecules in the aqueous humor (AqH) of children with uveitis in order to identify the factors that control the immune response in the eye. In this clinical laboratory investigation we analyzed, with a multiplex immunoassay, 16 immune mediators in the AqH of 25 children with uveitis and 6 children without uveitis. Increased levels of interleukin-2 (IL-2), IL-6, IL-10, IL-13, IL-18, interferon-gamma, tumor necrosis factor-alpha, soluble intercellular adhesion molecule-1, RANTES, IL-8 and interferon-inducible 10-kDa protein were found in the AqH of children with uveitis compared with controls. No significant differences were found for IL-1 beta, IL-4, IL-12 p-70, soluble vascular cell adhesion molecule 1 and Eotaxin. Lower levels of IL-10 and IL-8 were found in quiet stage uveitis (surgical) samples compared with active uveitis (diagnostic) samples and in samples of patients treated with methotrexate (MTX) compared with samples of patients not treated with MTX. Lower levels of IL-10 were as well found in samples taken during the first 3 months after the diagnosis of uveitis than samples taken later during the disease process. No significant differences were found between patients treated with or without topical or systemic (perioperative and long term) corticosteroids. In conclusion, in children with uveitis, multiple intraocular cytokines, chemokines and soluble adhesion molecules are increased in the AqH regardless of active or inactive inflammation. Whether the IL-8 and IL-10 levels in AqH of children with uveitis are correlated with uveitis activity, early or late phase of the course of the disease and systemic treatment with MTX needs further investigation in a bigger study population.
Collapse
Affiliation(s)
- Karen M Sijssens
- F.C. Donders Institute of Ophthalmology, University Medical Center Utrecht, E.03.136, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
48
|
Cassoux N, Giron A, Bodaghi B, Tran THC, Baudet S, Davy F, Chan CC, Lehoang P, Merle-Béral H. IL-10 measurement in aqueous humor for screening patients with suspicion of primary intraocular lymphoma. Invest Ophthalmol Vis Sci 2007; 48:3253-9. [PMID: 17591896 PMCID: PMC2078609 DOI: 10.1167/iovs.06-0031] [Citation(s) in RCA: 144] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the value of IL-10 measurement in aqueous humor (AH) for screening in primary intraocular lymphoma (PIOL). METHODS One hundred consecutive diagnostic or therapeutic vitrectomies were performed in patients with uveitis. During surgery, 100 microL of both AH and pure vitreous was taken. IL-10 levels were determined with a standard quantitative sandwich enzyme immunoassay technique. Patients were distributed in two groups: 51 patients with proven PIOL, 108 patients with uveitis divided into 74 with uveitis of proven etiology and 34 with idiopathic uveitis. Groups were compared by ANOVA and the Tukey-Kramer test or nonparametric Wilcoxon test. Distributions were compared by using the chi(2) test. Segmentation was derived from the ROC curves by choosing a tradeoff between sensitivity and specificity. RESULTS In patients with PIOL, IL-10 mean values were 2205.5 pg/mL (median: 1467 pg/mL) in the vitreous and 543.4 pg/mL (median: 424 pg/mL) in AH. In patients with uveitis (idiopathic and diagnostic uveitis), mean values were 26.6 pg/mL (median: 8 pg/mL) in the vitreous, and 21.9 pg/mL (median: 8 pg/mL) in AH. IL-10 mean values were significantly different between patients with PIOL and patients with uveitis (P < 10(-3)). The areas under the curves were 0.989 and 0.962 for vitreous and AH, respectively. A cutoff of 50 pg/mL in the AH was associated with a sensitivity of 0.89 and a specificity of 0.93. In the vitreous, a cutoff value of 400 pg/mL yielded a specificity of 0.99 and a sensitivity of 0.8. CONCLUSIONS Diagnosis of PIOL is often made months or years after the initial onset of ocular symptoms. Cytology remains the gold standard for diagnosis. However, measurement of IL-10 in the AH is a good screening test to reduce diagnostic delays.
Collapse
Affiliation(s)
- Nathalie Cassoux
- Department of Ophthalmology, Hopital Pitié-Salpêtrière, Paris, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Haq E, Rohrer B, Nath N, Crosson CE, Singh I. S-nitrosoglutathione Prevents Interphotoreceptor Retinoid-Binding Protein (IRBP161–180)-Induced Experimental Autoimmune Uveitis. J Ocul Pharmacol Ther 2007; 23:221-31. [PMID: 17593005 DOI: 10.1089/jop.2007.0023] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Experimental autoimmune uveitis (EAU), an animal model of human uveitis, is an organ-specific autoimmune disease mediated by various inflammatory cytokines. In particular, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta and interferon (IFN)-gamma are known to play a role in its pathogenesis. S-nitrosothiol S-nitrosoglutathione (GSNO), a slow nitric oxide (NO) donor, was reported to have beneficial effects in inflammatory disease in ischemia-reperfusion injury. The efficacy of GSNO treatment on interphotoreceptor retinoid-binding protein (IRBP)-induced EAU was investigated, using functional, histologic, and immunologic readouts. METHODS Mice were immunized with a single injection of IRBP(161180) peptide to induce EAU, followed by a daily treatment with GSNO (1 mg/kg). Electroretinogram (ERG) analysis, histopathology, and immunologic responses to IRBP were analyzed. The effects of GSNO treatment on the antigen-specific T-cell recall responses and their cytokine production were determined. RESULTS A single immunization of IRBP(161180) peptide led to significant structural damage of the retina and concomitant elimination of ERGs. Daily oral GSNO treatment from days 1-14 following immunization was found to be effective against IRBP-induced EAU. Histopathologic and ERG analysis both demonstrated significant retinal protection in GSNO-treated mice. The GSNO treatment of EAU animals significantly attenuated the levels of TNF-alpha, IL-1beta, IFN-gamma, and IL-10 in retinas, as measured by quantitative real-time polymerase chain reaction analysis. The splenocytes isolated from EAU- and GSNO-treated mice had lower antigen-specific T-cell proliferation in response to IRBP protein, and their cytokine production was inhibited. CONCLUSIONS The oral administration of GSNO significantly suppressed the levels of inflammatory mediators in the retinas of EAU mice. This suppression was associated with the maintenance of normal retinal histology and function. These results clearly demonstrated the therapeutic potential of GSNO in EAU, and provide new insights for the treatment of human uveitis.
Collapse
Affiliation(s)
- Ehtishamul Haq
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA
| | | | | | | | | |
Collapse
|
50
|
Guenane H, Hartani D, Chachoua L, Lahlou-Boukoffa OS, Mazari F, Touil-Boukoffa C. [Production of Th1/Th2 cytokines and nitric oxide in Behçet's uveitis and idiopathic uveitis]. J Fr Ophtalmol 2007; 29:146-52. [PMID: 16523155 DOI: 10.1016/s0181-5512(06)73762-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the role of Th1 (IFN-gamma and IL-12), Th2 (IL-10) cytokines and nitric oxide (NO) in the immunopathologic mechanisms of uveitis related to Behçet's disease and isolated idiopathic uveitis. PATIENTS AND METHOD This study was conducted on 24 patients with Behçet's syndrome who had active uveitis, ten of whom showed isolated uveitis classified as idiopathic uveitis, and 13 healthy controls. The levels of IFN-gamma, IL-12 and IL-10 in sera and supernatants of PBMC cultures stimulated by PHA were estimated using immunoenzymatic dosage (ELISA sandwich according to the methods recommended by Immunotech France). The production of NO was measured in vivo and in vitro for the same patients using the modified Griess method. RESULTS The induction of IFN-gamma and IL-12 was higher in the two groups of patients than in the controls (P<0.001). Significant IL-10 levels were recorded in 56.5% of patients with Behçet's disease presenting uveitis versus 30% of patients with idiopathic uveitis. NO production was more pronounced in idiopathic uveitis than in Behçet's syndrome (P<0.02). CONCLUSION The predominance of the Th1 profile was associated with high production of NO in idiopathic uveitis. A Th1/Th2 profile with a moderated increase in NO production was observed in Behçet's disease. Our data have a clinical impact. The observation of combined Th1/Th2 cytokines and NO elevation in both in vivo an in vitro experiments could have a predictive value in characterizing uveitis associated with Behçet's disease.
Collapse
Affiliation(s)
- H Guenane
- Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, USTHB Bab Ezzouar, Alger, Algérie.
| | | | | | | | | | | |
Collapse
|