Chan C-C, Reed G F, Kim Y, Agrón E, Buggage R R
National Eye Institute/NIH, Bldg 10, Room 10N103,10 Center Drive, Bethesda, MD 20892-1857, USA.
Br J Ophthalmol. 2004 Dec;88(12):1506-9. doi: 10.1136/bjo.2004.048595.
BACKGROUND/AIMS: Pregnancy and the postpartum period are associated with the activity of autoimmune diseases including uveitis. Although the exact mechanism is unknown, hormones are reported to alter inflammatory cytokines and influence disease activity. The authors studied ocular inflammation, female hormones, and serum cytokine levels during and after pregnancy.
A prospective, observational case study was conducted. Four pregnant women in their first trimester with chronic non-infectious uveitis were followed monthly until 6 months after delivery. Serum female hormones (oestrogen, progesterone, prolactin) and various cytokines (IL-2, IL-4, IL-5, IL-6, IL-10, IFN-gamma, and TGF-beta) were measured by ELISA.
The four patients had five full term pregnancies. Uveitis activity decreased after the first trimester but flared in the early postpartum period. Serum female hormones, highly elevated during pregnancy, drastically dropped post partum. Cytokine levels except TGF-beta were mostly undetectable.
Female hormones and TGF-beta may contribute to the activity of uveitis during pregnancy and the postpartum period.
背景/目的：妊娠和产后时期与包括葡萄膜炎在内的自身免疫性疾病活动相关。尽管确切机制尚不清楚，但据报道激素会改变炎性细胞因子并影响疾病活动。作者研究了妊娠期间及产后的眼部炎症、女性激素和血清细胞因子水平。
进行了一项前瞻性观察性病例研究。对4例孕早期患有慢性非感染性葡萄膜炎的孕妇每月进行随访，直至产后6个月。通过酶联免疫吸附测定法检测血清女性激素（雌激素、孕酮、催乳素）和各种细胞因子（白细胞介素-2、白细胞介素-4、白细胞介素-5、白细胞介素-6、白细胞介素-10、γ-干扰素和转化生长因子-β）。
4例患者共经历5次足月妊娠。葡萄膜炎活动在孕早期后降低，但在产后早期复发。血清女性激素在妊娠期间大幅升高，产后急剧下降。除转化生长因子-β外，细胞因子水平大多无法检测到。
女性激素和转化生长因子-β可能在妊娠和产后时期对葡萄膜炎的活动有影响。
