a Department of Ophthalmology , University Medical Centre Utrecht , Utrecht , The Netherlands.
b Laboratory of Translational Immunology , University Medical Centre Utrecht , Utrecht , The Netherlands.
Expert Rev Clin Immunol. 2016 Dec;12(12):1359-1362. doi: 10.1080/1744666X.2016.1241709. Epub 2016 Oct 6.
In this report we describe, for the first time, the activation of the peripheral immune compartment in a patient with a CRB1 linked retinal degenerative disease, masquerading as intermediate uveitis.
To monitor the immune system during systemic immunosuppressive treatment, given for the initial diagnosis of intermediate uveitis, blood samples were taken before and during therapy, for analysis of peripheral blood mononuclear cell-subsets and circulating immune mediators.
The levels of various pro-inflammatory immune mediators (including MIF, TSLP, CCL2/MCP-1, CXCL9, CXCL10, IFN-β, IL-6, IL-17, IL-21, IL-22, and IL-23) were elevated in serum at the first time point, and decreased under immunosuppressive treatment. In parallel, the frequency of activated (CD86+) CD1c+ myeloid dendritic cells in blood was proportional to the central foveal thickness measured by optical coherence tomography.
These observations challenge the current view on the distinct pathophysiology of retinal degenerative and retinal inflammatory conditions in this patient.
在本报告中,我们首次描述了一位患有 CRB1 相关视网膜退行性疾病的患者外周免疫细胞的激活情况,这种疾病表现为中间葡萄膜炎。
为了监测全身性免疫抑制治疗期间的免疫系统,我们在初始诊断为中间葡萄膜炎时进行了治疗,并在治疗前后采集了血液样本,用于分析外周血单个核细胞亚群和循环免疫介质。
在第一个时间点,血清中各种促炎免疫介质(包括 MIF、TSLP、CCL2/MCP-1、CXCL9、CXCL10、IFN-β、IL-6、IL-17、IL-21、IL-22 和 IL-23)的水平升高,并在免疫抑制治疗下降低。同时,血液中活化的(CD86+)CD1c+髓样树突状细胞的频率与光学相干断层扫描测量的中央凹厚度成正比。
这些观察结果挑战了当前关于该患者视网膜退行性和视网膜炎症性疾病的不同病理生理学的观点。