Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
PLoS One. 2018 Jun 26;13(6):e0199301. doi: 10.1371/journal.pone.0199301. eCollection 2018.
Posner-Schlossman-Syndrome (PSS) is clinically characterized by acute, recurrent, mild, unilateral uveitis anterior accompanied by elevated intraocular pressure (IOP). Fuchs´ Uveitis (FU) is a chronic, low-grade-inflammatory disorder, involving anterior uvea and vitreous. The clinical findings show remarkable similarities as well as differences. In our study, we determine the composition of immune mediators in aqueous humor of patients with PSS and FU and evaluate if immune mediators play a crucial role in specific viral intraocular inflammation and IOP rises. Aqueous humor samples from 81 uveitis patients (= eyes) presenting with either PSS or FU were collected at one time point. Local intraocular antibody synthesis to rubella virus was confirmed in 65 patients, whereas 16 were tested positively for human cytomegalovirus. Thirteen patients with PSS and 10 patients with FU were treated with glaucoma medications. Additionally, 11 cataract patients acted as control group. Immune mediator concentrations were measured by Bio-Plex Pro assay. We observed in both PSS (IFN-γ: 174.9 pg/mL; TNF-α: 25.1 pg/mL) and FU (IFN-γ: 25.4 pg/mL; TNF-α: 27.2 pg/mL) groups a significantly increased level of T-helper 1 immune mediators compared to controls (IFN-γ, TNF-α: 0 pg/mL) [median]. Notably, PSS patients (IL-1RA: 73.4 pg/mL; IL-8: 199.4 pg/mL; IL-10: 33.4 pg/mL; IP-10: 126350 pg/mL) showed a stronger and more active ocular inflammatory response, than FU patients (IL-1RA: 4.3 pg/mL; IL-8: 72.4 pg/mL; IL-10: 1.6 pg/mL; IP-10: 57400 pg/mL). Furthermore, a negative correlation between mediators and IOP was seen in the PSS group, potentially caused by acetazolamide-treatment. Our findings show that immune mediators play a crucial role in specific viral intraocular inflammation and influence IOP levels. Remarkable similarities but also significant differences of immune mediator concentrations are apparent in PSS compared to FU. High concentrations of IL-1RA, IL-8, IL-10, and IP-10 correlate with active inflammation in PSS, while FU may trigger chronic inflammation. Our data also substantiated a very similar composition of cytokines in those patients from the PSS group suffering from ocular hypertension and thus offers a potential explanation model for a negative correlation between mediators and IOP.
Posner-Schlossman 综合征 (PSS) 临床上表现为急性、复发性、轻度、单侧前葡萄膜炎，伴有眼内压 (IOP) 升高。Fuchs 葡萄膜炎 (FU) 是一种慢性、低度炎症性疾病，累及前葡萄膜和玻璃体。临床发现显示出显著的相似性和差异。在我们的研究中，我们确定了 PSS 和 FU 患者房水中免疫介质的组成，并评估了免疫介质是否在特定的病毒眼内炎症和 IOP 升高中起关键作用。在一个时间点收集了 81 名患有 PSS 或 FU 的葡萄膜炎患者 (=眼睛) 的房水样本。在 65 名患者中证实了局部眼内抗风疹病毒抗体合成，而在 16 名患者中检测到人类巨细胞病毒阳性。13 名 PSS 患者和 10 名 FU 患者接受了青光眼药物治疗。此外，11 名白内障患者作为对照组。通过 Bio-Plex Pro 测定法测量免疫介质浓度。我们观察到 PSS 组 (IFN-γ：174.9 pg/mL；TNF-α：25.1 pg/mL) 和 FU 组 (IFN-γ：25.4 pg/mL；TNF-α：27.2 pg/mL) 的 T 辅助 1 免疫介质水平明显高于对照组 (IFN-γ，TNF-α：0 pg/mL)[中位数]。值得注意的是，PSS 患者 (IL-1RA：73.4 pg/mL；IL-8：199.4 pg/mL；IL-10：33.4 pg/mL；IP-10：126350 pg/mL) 表现出比 FU 患者更强和更活跃的眼内炎症反应 (IL-1RA：4.3 pg/mL；IL-8：72.4 pg/mL；IL-10：1.6 pg/mL；IP-10：57400 pg/mL)。此外，PSS 组的介质与 IOP 之间呈负相关，这可能是由于乙酰唑胺治疗所致。我们的发现表明，免疫介质在特定的病毒眼内炎症中起关键作用，并影响 IOP 水平。与 FU 相比，PSS 中免疫介质浓度的显著相似性和显著差异。IL-1RA、IL-8、IL-10 和 IP-10 的高浓度与 PSS 中的活跃炎症相关，而 FU 可能引发慢性炎症。我们的数据还证实了 PSS 组中患有眼高压的患者的细胞因子组成非常相似，这为介质与 IOP 之间的负相关提供了潜在的解释模型。
