Group of Ocular Inflammation, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain.
Department of Ophthalmology, BioCruces Health Research Institute, Hospital Cruces, University of the Basque Country, Baracaldo, Spain.
Front Immunol. 2020 Sep 25;11:579005. doi: 10.3389/fimmu.2020.579005. eCollection 2020.
To investigate whether systemic immune mediators and circulating regulatory T cells (Tregs) could be prognostic factors for anatomic outcomes in macular edema secondary to non-infectious uveitis (UME).
Multicenter, prospective, observational, 12-month follow-up study of 60 patients with UME. Macular edema was defined as central subfield thickness (CST) > 300 μm measured with spectral domain optical coherence tomography (SD-OCT). Serum samples and peripheral blood mononuclear cells (PBMC) were obtained from venous blood extraction at baseline. Serum levels of IL-1β, IL-6, IL-8, IL-17, MCP-1, TNF-α, IL-10, and VEGF were determined by Luminex. Tregs population, defined as CD3CD4FoxP3 in PBMC, was determined by flow cytometry. Main outcome measure was the predictive association between searched mediators and CST sustained improvement, defined as CST < 300 microns or a 20% CST decrease, at 6 months maintained until 12-months compared to baseline levels.
Multivariate logistic regression analysis showed an association between CST sustained improvement at 12 months follow-up and IL-6 and Tregs baseline levels. Higher IL-6 levels were associated with less events of UME improvement (OR: 0.67, 95% CI (0.45-1.00), P = 0.042), whereas higher levels of Tregs favored such improvement (OR: 1.25, 95% CI: 1.12-2.56, P = 0.049).
Increased levels of Tregs and reduced levels of IL-6 in serum may be prognostic factors of sustained anatomical improvement in UME. These findings could enforce the opportunity to develop more efficient and personalized therapeutic approaches to improve long-term visual prognosis in patients with UME.
探讨系统性免疫介质和循环调节性 T 细胞（Tregs）是否可作为非感染性葡萄膜炎（UME）继发黄斑水肿解剖学结局的预后因素。
对 60 例 UME 患者进行了多中心、前瞻性、观察性、12 个月随访研究。黄斑水肿定义为采用谱域光学相干断层扫描（SD-OCT）测量的中央视网膜下厚度（CST）>300μm。从静脉血采集时获得血清样本和外周血单个核细胞（PBMC）。通过 Luminex 测定血清中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-17（IL-17）、单核细胞趋化蛋白-1（MCP-1）、肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）和血管内皮生长因子（VEGF）的水平。通过流式细胞术确定 PBMC 中 CD3CD4FoxP3 定义的 Tregs 群体。主要观察指标是搜索到的介质与 CST 持续改善之间的预测相关性，CST 持续改善定义为与基线水平相比，6 个月时 CST<300μm 或 CST 降低 20%，并持续至 12 个月。
多变量逻辑回归分析显示，12 个月随访时 CST 持续改善与 IL-6 和 Tregs 基线水平之间存在关联。较高的 IL-6 水平与 UME 改善事件较少相关（比值比：0.67，95%置信区间（0.45-1.00），P=0.042），而较高的 Tregs 水平有利于这种改善（比值比：1.25，95%置信区间：1.12-2.56，P=0.049）。
血清中 Tregs 水平升高和 IL-6 水平降低可能是 UME 持续解剖学改善的预后因素。这些发现可能会加强机会，开发更有效和个性化的治疗方法，以改善 UME 患者的长期视力预后。
