Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa, São Paulo, Brazil.
Federal University of São Paulo, São Paulo, Brazil.
BMC Ophthalmol. 2023 Jul 17;23(1):326. doi: 10.1186/s12886-023-03013-0.
Recent studies have presented inflammatory features on keratoconus (KC) and many inflammatory markers are described in the tears of patients with this disease. The KC pathogenesis is still unknown just like the correlation with inflammatory patterns. However, environmental and genetic issues may be part of the progress of KC. In addition, some systemic features, such as allergy and obesity, seem to be related to the progression of KC. Our purpose was to evaluate the neuropeptides vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), chemokines ligand 2 (CCL-2) and 5 (CCL-5), and interleukins 6 (IL-6) and 8 (IL-8) on corneal epithelial cells and blood of patients with KC and in healthy controls. In addition, the neutrophil-to-lymphocyte ratio (NLR) was evaluated to predict inflammation.
This including prospective observational study included 32 KC patients who underwent corneal crosslinking (CXL) and 32 control patients who underwent photorefractive keratectomy (PRK). Patients' corneal epithelial cells were removed surgically, and blood (buffy coat) was analyzed. Samples in triplicate were evaluated on rt-PCR for neuropeptides (VIP e NPY), interleukins (IL-6 e IL-8), and chemokines (CCL-2 and CCL-5).
Our study showed statistically higher CCL-5 and IL-8 on corneal epithelial cells in patients with KC. Blood cells were statistically higher in VIP and NPY in the KC group. Interleukin-8 on blood cells was statistically significant in KC'S group; for CCL-2 and CCL-5 they were statistically lower in patients with KC compared with controls. NLR showed no difference between the groups.
Our data support the findings of other studies that suggested altering KC status, such as inflammatory corneal disease. The presence of IL-8 in the cornea and blood samples of KC's group suggested systemic disease with a possible local or repercussion action. Further studies are warranted to elucidate KC pathogenesis and its correlation to systemic disease.
最近的研究表明圆锥角膜（KC）存在炎症特征，许多炎症标志物在患有这种疾病的患者的泪液中被描述。KC 的发病机制仍然未知，就像与炎症模式的相关性一样。然而，环境和遗传问题可能是 KC 进展的一部分。此外，一些全身性特征，如过敏和肥胖，似乎与 KC 的进展有关。我们的目的是评估神经肽血管活性肠肽（VIP）、神经肽 Y（NPY）、趋化因子配体 2（CCL-2）和 5（CCL-5）以及白细胞介素 6（IL-6）和 8（IL-8）在 KC 患者和健康对照者的角膜上皮细胞和血液中的表达。此外，还评估了中性粒细胞与淋巴细胞比值（NLR）以预测炎症。
这是一项包括前瞻性观察性研究，共纳入 32 名接受角膜交联（CXL）的 KC 患者和 32 名接受光屈光性角膜切削术（PRK）的对照患者。患者的角膜上皮细胞通过手术切除，分析血液（白细胞层）。对神经肽（VIP 和 NPY）、白细胞介素（IL-6 和 IL-8）和趋化因子（CCL-2 和 CCL-5）的三重样本进行 rt-PCR 评估。
我们的研究表明，KC 患者的角膜上皮细胞中 CCL-5 和 IL-8 的表达明显升高。KC 组血液细胞中的 VIP 和 NPY 明显升高。KC 组血液细胞中的白细胞介素-8 有统计学意义；对于 CCL-2 和 CCL-5，与对照组相比，KC 患者的水平明显较低。NLR 两组间无差异。
我们的数据支持其他研究的发现，表明 KC 状态的改变，如炎症性角膜疾病。KC 组角膜和血液样本中存在 IL-8，提示存在全身性疾病，可能存在局部或继发作用。需要进一步研究阐明 KC 的发病机制及其与全身性疾病的相关性。
