Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba 2728-513, Japan.
Department of Ophthalmology, Kumamoto University, Kumamoto 8608-556, Japan.
Int J Mol Sci. 2021 Nov 12;22(22):12268. doi: 10.3390/ijms222212268.
Peripheral anterior synechiae (PAS) after corneal transplantation leads to refractory glaucoma and permanent loss of vision. However, the exact mechanism remains elusive. This study aimed to evaluate the association between cytokine levels in the aqueous humor (AqH) and the progression of PAS after penetrating keratoplasty (PKP). We measured 20 cytokine levels in AqH and assessed the correlation with PAS progression after PKP in 85 consecutive patients who underwent PKP. We also evaluated age-dependent alterations in PAS and cytokine levels in DBA2J mice. PAS developed in 38 (44.7%) of 85 eyes after PKP. The incidence of intraocular pressure increase after PKP was significantly greater in eyes with PAS (26.3%) than in those without PAS (2%, = 0.0009). The PAS area at 12 months after PKP was significantly positively correlated with the preoperative levels of interleukin (IL)-6, interferon (IFN)-γ and monocyte chemotactic protein (MCP)-1 ( ≤ 0.049). In the DBA2J mice, an experimental glaucoma model that developed PAS at 50 weeks, the AqH levels of IL-2, IL-6, IL-10, IFN-γ, tumor necrosis factor-α, MCP-1 and granulocyte-macrophage colony-stimulating factor (GM-CSF) significantly increased at 50 weeks compared to 8 weeks ( ≤ 0.021). In conclusion, inflammatory alterations in the AqH microenvironment, such as high preoperative specific cytokine levels, can lead to PAS formation and glaucoma.
周边前黏连（PAS）是角膜移植术后导致难治性青光眼和永久性视力丧失的主要原因之一，但确切的发病机制尚不清楚。本研究旨在评估房水中细胞因子水平与穿透性角膜移植术后 PAS 进展之间的关系。我们检测了 85 例连续接受穿透性角膜移植术（PKP）患者房水中的 20 种细胞因子水平，并评估了这些细胞因子水平与 PAS 进展的相关性。此外，我们还评估了 DBA2J 小鼠中 PAS 和细胞因子水平随年龄的变化。在 85 只接受 PKP 的眼中，有 38 只（44.7%）发生 PAS。PKP 后眼压升高的发生率在伴有 PAS 的眼中（26.3%）显著高于不伴有 PAS 的眼中（2%， = 0.0009）。PKP 后 12 个月的 PAS 面积与术前白细胞介素（IL）-6、干扰素（IFN）-γ和单核细胞趋化蛋白（MCP）-1水平呈显著正相关（ ≤ 0.049）。在 DBA2J 小鼠中，一种在 50 周时发生 PAS 的实验性青光眼模型中，房水中的 IL-2、IL-6、IL-10、IFN-γ、肿瘤坏死因子-α、MCP-1 和粒细胞-巨噬细胞集落刺激因子（GM-CSF）水平在 50 周时与 8 周时相比显著升高（ ≤ 0.021）。总之，房水微环境中的炎症改变，如术前特定细胞因子水平升高，可能导致 PAS 形成和青光眼。
