Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Graefes Arch Clin Exp Ophthalmol. 2022 Aug;260(8):2675-2686. doi: 10.1007/s00417-022-05600-1. Epub 2022 Mar 1.
Uveitis accounts for 10-15% of all cases of blindness in the developed world. Uveitic macular edema (UME) is a primary cause of permanent visual impairment in patients with uveitis. Because proinflammatory mediators elicit inflammation and lead to UME, we determined the profiles of proinflammatory mediators associated with complications, such as ME, in the vitreous humor of patients with panuveitis related to Behçet's disease (BD) and sarcoidosis.
In this retrospective study, we enrolled 21 patients with uveitis, including 6 with BD and 15 with sarcoidosis, and 15 patients with idiopathic epiretinal membrane (iERM) at the Department of Ophthalmology, Kyushu University Hospital, between January 2008 and April 2016. Vitreous concentrations of 32 proinflammatory mediators, including cytokines and soluble receptors of tumor necrosis factor (TNF) and interleukin (IL)-6 families, were assessed using a bead-based multiplex assay and their association with clinical data was examined.
The levels of proinflammatory mediators, including a proliferation-inducing ligand (APRIL), B cell activating factor belonging to the TNF family (BAFF), soluble cluster of differentiation 30 (sCD30), soluble TNF receptor-1 (sTNFR1), sTNFR2, TNF-α, IL-6, and soluble IL-6 receptor-α (sIL-6Rα), were significantly higher in patients with uveitis. With regard to clinical parameters in patients with uveitis, vitreous levels of BAFF and sIL-6Rα were prominently elevated in patients with UME compared to in those without UME (P < 0.01, respectively).
Our results suggest that elevated vitreous levels of BAFF and sIL-6Rα are associated with the pathogenesis of UME in patients with panuveitis related to BD and sarcoidosis.
葡萄膜炎占发达国家所有失明病例的 10-15%。葡萄膜炎性黄斑水肿(UME)是葡萄膜炎患者永久性视力损害的主要原因。由于前炎性介质引发炎症并导致 UME,我们确定了与并发症(如 ME)相关的前炎性介质在与 Behçet 病(BD)和结节病相关的全葡萄膜炎患者的玻璃体中的特征。
在这项回顾性研究中,我们招募了 21 名葡萄膜炎患者,包括 6 名 BD 和 15 名结节病患者,以及 2008 年 1 月至 2016 年 4 月在九州大学医院眼科的 15 名特发性视网膜前膜(iERM)患者。使用基于珠的多重测定法评估 32 种前炎性介质(包括细胞因子和肿瘤坏死因子(TNF)和白细胞介素(IL)-6 家族的可溶性受体)的玻璃体浓度,并检查其与临床数据的关联。
葡萄膜炎患者的前炎性介质水平(包括增殖诱导配体(APRIL)、B 细胞激活因子属于 TNF 家族(BAFF)、可溶性 CD30(sCD30)、可溶性 TNF 受体-1(sTNFR1)、sTNFR2、TNF-α、IL-6 和可溶性 IL-6 受体-α(sIL-6Rα))明显升高。就葡萄膜炎患者的临床参数而言,与无 UME 的患者相比,UME 患者的玻璃体 BAFF 和 sIL-6Rα 水平明显升高(P <0.01)。
我们的结果表明,BD 和结节病相关的全葡萄膜炎患者玻璃体中 BAFF 和 sIL-6Rα 的升高与 UME 的发病机制有关。