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Maehara H, Norikawa K, Tanaka K, Kato Y, Kasai A, Omori T, Machida T, Sekine H, Sekiryu T. Tear fluid and complement activation products in tears after ocular surgery. BMC Ophthalmol 2023; 23:329. [PMID: 37464366 DOI: 10.1186/s12886-023-03037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/11/2023] [Indexed: 07/20/2023] Open
Abstract
PURPOSE Due to technological advancements, surgical invasiveness has been reduced. However, cataract surgery has been implicated in causing postoperative inflammation, including dry eye syndrome. The innate immune system may be involved in postoperative inflammation, and complement activation could potentially play a crucial role in defense against pathogens, homeostasis, and wound healing. To investigate changes in the tear film complement activation products (CAPs) and ocular surface after vitrectomy combined with cataract surgery. METHODS Forty-three patients (23 women; median age, 69 years) were enrolled in this prospective study and underwent phacoemulsification and vitrectomy. We measured Schirmer's test (ST) and CAPs in the tears at baseline (the day before surgery), 4 days and 1 month after the surgery. Tears were collected in microtubes. The CAPs in the tear fluid were analyzed by cytometric bead array. RESULTS The median ST (8.5 mm) at baseline increased to 16 mm at 4 days ( P < 0.001) and 10 mm at 1 month (P = 0.44). The C3a levels (1202 pg/ml) at baseline increased to 2753 pg/ml at 4 days (P < 0.001), and 1763 pg/ml at 1 month (P = 0.049). The C4a levels (476 pg/ml) at baseline increased to 880 pg/ml at 4 days (P < 0.001), and 657 pg/ml at 1 month (P = 0.013). The C5a levels (22.6 pg/ml) at baseline increased to 470.9 pg/ml at 4 days (P < 0.001), and 38.3 pg/ml at 1 month (P = 0.0048). The surgical eyes were divided into the short ST group (≦ 10 mm, n = 22) and long ST group (> 10 mm, n = 21) based on the preoperative ST values. At 1 month postoperatively, the C3a levels were 2194 pg/ml in the preoperative short ST group and 1391 pg/ml in the long ST group, with significantly higher C3a concentrations in the short ST group (P < 0.001). CONCLUSIONS The CAPs levels in tears increased after vitrectomy combined with cataract surgery. A preoperative deficit in tear secretion might induce prolonged complement activation and delayed recovery of ocular surface parameters postoperatively.
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Affiliation(s)
- Hiroki Maehara
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Koki Norikawa
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Keiichiro Tanaka
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Yutaka Kato
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Akihito Kasai
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Tomoko Omori
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takeshi Machida
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideharu Sekine
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan.
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Thomas AM, Chaban V, Pischke SE, Orrem HL, Bosnes V, Sunde K, Seljeflot I, Lundqvist C, Nakstad ER, Andersen GØ, Schjalm C, Mollnes TE, Barratt-Due A. Complement ratios C3bc/C3 and sC5b-9/C5 do not increase the sensitivity of detecting acute complement activation systemically. Mol Immunol 2021; 141:273-279. [PMID: 34906905 DOI: 10.1016/j.molimm.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Complement activation plays an important pathogenic role in numerous diseases. The ratio between an activation product and its parent protein is suggested to be more sensitive to detect complement activation than the activation product itself. In the present study we explored whether the ratio between the activation product and the parent protein for C3 (C3bc/C3) and for C5 (sC5b-9/C5) increased the sensitivity to detect complement activation in acute clinical settings compared to the activation product alone. MATERIALS AND METHODS Samples from patients with acute heart failure following ST-elevated myocardial infarction (STEMI) and from patients with out-of-hospital cardiac arrest (OHCA) were used. C3, C3bc and C5, sC5b-9 were analysed in 629 and 672 patient samples, respectively. Healthy controls (n = 20) served to determine reference cut-off values for activation products and ratios, defined as two SD above the mean. RESULTS Increased C3bc/C3- and sC5b-9/C5 ratios were vastly dependent on C3bc and sC5b-9. Thus, 99.5 % and 98.1 % of the increased C3bc/C3- and sC5b-9/C5 ratios were solely dependent on increased C3bc and sC5b-9, respectively. Significantly decreased C3 and C5 caused increased ratios in only 3/600 (0.5 %) and 4/319 (1.3 %) samples, respectively. Strong correlations between C3bc and C3bc/C3-ratio and between sC5b-9 and sC5b-9/C5-ratio were found in the STEMI- (r = 0.926 and r = 0.786, respectively) and the OHCA-population (r = 0.908 and r = 0.843, respectively; p < 0.0001 for all). Importantly, sC5b-9 identified worse outcome groups better than sC5b-9/C5-ratio. CONCLUSION C3bc and sC5b-9 were sensitive markers of complement activation. The ratios of C3bc/C3 and sC5b-9/C5 did not improve detection of complement activation systemically.
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Affiliation(s)
- Anub Mathew Thomas
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Norway
| | - Viktoriia Chaban
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway
| | - Søren E Pischke
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway
| | - Hilde Lang Orrem
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway
| | - Vidar Bosnes
- Department of Immunology, Section of Medical Immunology, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sunde
- Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, University of Oslo, Norway; Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Norway; Department of Cardiology, Oslo University Hospital, Norway
| | - Christofer Lundqvist
- Institute of Clinical Medicine, University of Oslo, Norway; Department of Neurology, Akershus University Hospital, Oslo, Norway; Health Services Research Unit, Akershus University Hospital, Oslo, Norway
| | - Espen Rostrup Nakstad
- Norwegian National Unit for CBRNE Medicine, Division of Medicine, Oslo University Hospital, Norway
| | | | - Camilla Schjalm
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway
| | - Tom Eirik Mollnes
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Research Laboratory, Nordland Hospital, Bodø, Norway; K.G. Jebsen TREC, University of Tromsø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Barratt-Due
- Department of Immunology, Oslo University Hospital and University of Oslo, Norway; Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
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