Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Exp Eye Res. 2018 Nov;176:141-146. doi: 10.1016/j.exer.2018.07.012. Epub 2018 Jul 10.
A high prevalence of serum antiretinal antibodies (ARAs) in patients with uveitis has been previously described, though their clinical role remains elusive. Assessment of intraocular ARAs may provide further insight into the pathogenesis of diverse uveitis entities. In this study we investigate the prevalence of multiple specific anti-ocular antibodies (AOcAs), including ARAs, in intraocular fluid of patients with uveitis. Autoantibody profiling with 188 different ocular antigens was performed by a multiplex immunoassay with intraocular fluid samples of 76 patients with uveitis. Clinical data from uveitis patients were collected and statistical analyses were executed to evaluate associations between intraocular AOcAs and clinical characteristics. Controls consisted of 19 intraocular fluid samples from cataract patients. A spectrum of 22 different AOcAs was present in higher levels in patients with uveitis than in controls (p < 0.05), but in moderately elevated titers (<2x). High elevations of intraocular AOcAs in uveitis (>5x compared to cataract) were observed in varicella zoster virus-induced uveitis, multiple sclerosis-associated uveitis and patients with unexplained uveitis but positive quantiferon test. Presence of macular edema was associated with increased intraocular levels of tyrosinase antibodies. Our results show that patients with uveitis are characterized by the presence of a broad spectrum of moderately elevated levels of intraocular AOcAs, and high intraocular AOcA levels were found in several specific uveitis entities. This study favors secondary production of AOcAs and not their inciting role.
先前已有研究描述了葡萄膜炎患者血清抗视网膜抗体（ARAs）的高患病率，但它们的临床作用仍不清楚。评估眼内 ARAs 可能有助于进一步了解多种葡萄膜炎的发病机制。在这项研究中，我们调查了葡萄膜炎患者眼内液中多种特定的抗眼抗体（AOcAs），包括 ARAs 的患病率。通过多重免疫分析，使用 76 例葡萄膜炎患者的眼内液样本，对 188 种不同的眼抗原进行了自身抗体分析。收集了葡萄膜炎患者的临床数据，并进行了统计分析，以评估眼内 AOcAs 与临床特征之间的关联。对照组由 19 例白内障患者的眼内液样本组成。与对照组相比（p<0.05），葡萄膜炎患者的眼内液中存在更多种类的 22 种 AOcAs，且浓度更高（<2x）。在水痘带状疱疹病毒诱导的葡萄膜炎、多发性硬化相关性葡萄膜炎和不明原因的葡萄膜炎但定量干扰素检测阳性的患者中，眼内 AOcAs 水平显著升高（与白内障相比>5x）。黄斑水肿的存在与眼内酪氨酸酶抗体水平升高有关。我们的结果表明，葡萄膜炎患者的特点是存在广泛的中等水平升高的眼内 AOcAs，并且在几种特定的葡萄膜炎实体中发现了高浓度的眼内 AOcAs。本研究倾向于 AOcAs 的继发性产生，而非其起始作用。
