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[幼年特发性关节炎相关葡萄膜炎患儿的细胞因子谱变化]

[Cytokine profile changes in children with juvenile idiopathic arthritis-associated uveitis].

作者信息

Drozdova E A, Yadykina E V, Mezentseva E A, Nikushkina K V

机构信息

South Ural State Medical University, 64 Vorovskogo St., Chelaybinsk, Russian Federation, 454092.

出版信息

Vestn Oftalmol. 2017;133(1):27-31. doi: 10.17116/oftalma2017133127-31.

Abstract

AIM

to identify the differences between serum cytokine profiles in juvenile idiopathic arthritis (JIA) with or without uveal tract inflammation.

MATERIAL AND METHODS

Serum cytokine profiles were studied in two groups of patients: 20 children with JIA and JIA-associated uveitis and 33 children, who had no signs of uveitis under basic therapy for their JIA. All the patients showed drug remission of articular syndrome. Inflammation of the choroid took the form of chronic anterior uveitis. The process was active in 95% of cases. The control group consisted of 35 children without rheumatic disease or other acute condition at the time of examination. Groups were comparable in terms of age and sex. Serum levels of TNF-α, IFN-γ, IL-17, IL-10 were measured by the enzyme multiplied immunoassay technique.

RESULTS

A statistically significant increase in TNF-α, IFN-γ, IL-17, and IL-10 levels was found in all patients as compared to the control group. A comparison drawn between serum cytokine levels of JIA patients and those, who also suffered from JIA-associated uveitis, revealed a decrease in IFN-γ and an increase in IL-10 in the latter group. There was also a statistically significant positive correlation between TNF-α and IFN-γ serum levels in patients with JIA-associated uveitis.

CONCLUSION

Development of uveitis in patients with drug remission of JIA occurs on the background of cytokine imbalance in the serum, in particular, increased concentrations of proinflammatory TNF-α and IL-17 cytokines along with reduced IFN-γ and increased IL-10 levels. This may be regarded as risk factors for ocular inflammation and should be taken into account when making treatment decisions.

摘要

目的

确定伴或不伴葡萄膜炎的幼年特发性关节炎(JIA)患者血清细胞因子谱的差异。

材料与方法

对两组患者的血清细胞因子谱进行研究:20例患有JIA及JIA相关葡萄膜炎的儿童,以及33例在JIA基础治疗下无葡萄膜炎体征的儿童。所有患者的关节综合征均达到药物缓解。脉络膜炎症表现为慢性前葡萄膜炎。该过程在95%的病例中呈活动状态。对照组由35名在检查时无风湿性疾病或其他急性病症的儿童组成。两组在年龄和性别方面具有可比性。采用酶放大免疫测定技术检测血清中TNF-α、IFN-γ、IL-17、IL-10的水平。

结果

与对照组相比,所有患者的TNF-α、IFN-γ、IL-17和IL-10水平均有统计学意义的升高。对JIA患者与同时患有JIA相关葡萄膜炎患者的血清细胞因子水平进行比较,发现后一组中IFN-γ降低而IL-10升高。在JIA相关葡萄膜炎患者中,TNF-α与IFN-γ血清水平之间也存在统计学意义的正相关。

结论

JIA药物缓解患者葡萄膜炎的发生是在血清细胞因子失衡的背景下,特别是促炎细胞因子TNF-α和IL-17浓度升高,同时IFN-γ降低以及IL-10水平升高。这可被视为眼部炎症的危险因素,在制定治疗决策时应予以考虑。

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