Skonieczna Katarzyna, Grabska-Liberek Iwona, Terelak-Borys Barbara, Jamrozy-Witkowska Agnieszka
Department of Ophthalmology, Medical Centre of Postgraduate Education, Warsaw, Poland.
Med Sci Monit. 2014 Jul 13;20:1201-9. doi: 10.12659/MSM.890548.
Although intraocular pressure is an important risk factor in glaucoma, there is growing body evidence indicating an immunological component in the pathogenesis of normal-tension glaucoma (NTG). The aim of this study was to determine if NTG coexists with elevated levels of autoantibodies detected in rheumatic diseases.
We enrolled 105 patients into the study: 35 with NTG, 34 with primary open-angle glaucoma (POAG), and 36 controls. All patients underwent ophthalmic examination and blood tests. Blood was examined for the level of: antibodies against antinuclear antibodies (ANA), antibodies to extractable nuclear antigens (ENA), immunoglobulins (IgG, IgA, IgM), rheumatoid factor, anti-citrullinated protein antibodies (ACPA), and antiphospholipid antibodies (anticardiolipin antibodies, beta2-glycoprotein I antibodies, antiprothrombin antibodies).
The level of ANA was increased among 6 patients in the NTG group (17.1%), 8 in the POAG group (23.5%), and 6 in the control group (16.5%). The difference was not statistically significant (p=0.97). None of the patients in the NTG, POAG, or control group had positive antibodies to ENA. The level of immunoglobulins IgG, IgM, and IgA in the 3 groups was similar and within normal values. The median level of rheumatoid factor and ACPA was the highest in the NTG group, but it was within normal laboratory values. There was a statistically significant difference between antiprothrombin antibodies IgG between the NTG and POAG group (p=0.01), but not between the NTG and control group (p=0.24).
The results of our study do not confirm the hypothesis that NTG coexists with elevated blood levels of antibodies, which are a characteristic feature of rheumatic diseases.
尽管眼压是青光眼的一个重要危险因素,但越来越多的证据表明,正常眼压性青光眼(NTG)的发病机制中存在免疫成分。本研究的目的是确定NTG是否与在风湿性疾病中检测到的自身抗体水平升高同时存在。
我们招募了105名患者参与研究:35名NTG患者、34名原发性开角型青光眼(POAG)患者和36名对照者。所有患者均接受眼科检查和血液检测。检测血液中的以下指标水平:抗核抗体(ANA)、可提取核抗原抗体(ENA)、免疫球蛋白(IgG、IgA、IgM)、类风湿因子、抗瓜氨酸化蛋白抗体(ACPA)和抗磷脂抗体(抗心磷脂抗体、β2糖蛋白I抗体、抗凝血酶原抗体)。
NTG组有6名患者(17.1%)ANA水平升高,POAG组有8名患者(23.5%)ANA水平升高,对照组有6名患者(16.5%)ANA水平升高。差异无统计学意义(p = 0.97)。NTG组、POAG组或对照组中均无患者ENA抗体呈阳性。三组中免疫球蛋白IgG、IgM和IgA的水平相似且在正常范围内。NTG组类风湿因子和ACPA的中位数水平最高,但在实验室正常范围内。NTG组和POAG组之间抗凝血酶原抗体IgG存在统计学显著差异(p = 0.01),但NTG组和对照组之间无差异(p = 0.24)。
我们的研究结果未证实NTG与血液中抗体水平升高同时存在的假设,而抗体水平升高是风湿性疾病的一个特征。