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自身免疫性视网膜病变患者免疫标志物与疾病及临床结局指标的相关性

Correlation of Immunological Markers with Disease and Clinical Outcome Measures in Patients with Autoimmune Retinopathy.

作者信息

Stanwyck Lynn K, Chan Weilin, Sood Arjun, Susarla Gayatri, Romano John, Pefkianaki Maria, Jayasundera Kanishka Thiran, Heckenlively John R, Lundy Steven K, Sobrin Lucia

机构信息

Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.

Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.

出版信息

Transl Vis Sci Technol. 2020 Jun 16;9(7):15. doi: 10.1167/tvst.9.7.15. eCollection 2020 Jun.

Abstract

PURPOSE

To determine if immunological markers (1) are significantly different between autoimmune retinopathy (AIR) patients and controls and (2) correlate with disease progression in AIR patients.

METHODS

We enrolled patients with a possible AIR diagnosis, as well as control participants without eye disease, autoimmunity, or cancer. Immunological markers were tested in all participants. In addition, AIR patients had up to three blood draws for testing over their disease course. For AIR patients, clinical measures, including visual acuity (VA) and Goldmann visual field (GVF) area, were recorded at each draw. We used the Mann-Whitney test to compare the immunological markers between AIR patients and controls. We used multilevel mixed-effect regression to investigate the correlation between markers and clinical parameters over time in AIR patients.

RESULTS

Seventeen patients with AIR and 14 controls were included. AIR patients had a higher percent of monocytes ( = 3.076, = 0.002). An increase in immunoglobulin G against recoverin was correlated with a VA decrease (β = 0.0044, < 0.0001). An increase in monocyte proportion was correlated with a decrease in GVF area (β = -7.27, = 0.0021). Several markers of B-cell depletion were correlated with GVF improvement.

CONCLUSIONS

Monocytes may play a role in AIR pathophysiology and be a disease activity marker. B-cell depletion markers correlated with clinical parameter improvement, particularly GVF.

TRANSLATIONAL RELEVANCE

This work elucidates immunologic markers that may improve the accuracy of diagnosis and treatment of AIR.

摘要

目的

确定自身免疫性视网膜病变(AIR)患者与对照组之间的免疫标志物是否存在显著差异,以及这些标志物与AIR患者疾病进展是否相关。

方法

我们纳入了可能诊断为AIR的患者,以及无眼部疾病、自身免疫或癌症的对照参与者。对所有参与者进行免疫标志物检测。此外,AIR患者在病程中最多进行三次血液抽取检测。对于AIR患者,每次抽取血液时记录包括视力(VA)和Goldmann视野(GVF)面积在内的临床指标。我们使用Mann-Whitney检验比较AIR患者与对照组之间的免疫标志物。我们使用多级混合效应回归研究AIR患者中标志物与临床参数随时间的相关性。

结果

纳入了17例AIR患者和14例对照。AIR患者的单核细胞百分比更高( = 3.076, = 0.002)。抗恢复蛋白的免疫球蛋白G升高与VA降低相关(β = 0.0044, < 0.0001)。单核细胞比例增加与GVF面积减小相关(β = -7.27, = 0.0021)。几种B细胞耗竭标志物与GVF改善相关。

结论

单核细胞可能在AIR病理生理过程中起作用,并且是一种疾病活动标志物。B细胞耗竭标志物与临床参数改善相关,尤其是GVF。

转化相关性

这项工作阐明了可能提高AIR诊断和治疗准确性的免疫标志物。

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