Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Colorado School of Public Health, University of Colorado School of Medicine, Aurora, CO, USA.
Transl Vis Sci Technol. 2023 Aug 1;12(8):1. doi: 10.1167/tvst.12.8.1.
Chronic local inflammation underlies the pathogenesis of age-related macular degeneration (AMD) causing damage to the neurosensory retina. However, there is minimal research on systemic cell-mediated inflammation in AMD. Interleukin-4 (IL-4) is an immunoregulatory cytokine with an important role in modulating inflammation in chronic immune mediated disease. The purpose of this study was to: (1) investigate the role of systemic IL-4 in patients with intermediate AMD (iAMD) and in geographic atrophy (GA), an advanced form of AMD, compared to controls without AMD, and (2) determine if IL-4 levels are moderated by sex.
We examined plasma levels of IL-4 in patients with iAMD, GA, and controls without AMD included in the University of Colorado AMD registry (August 2014 to June 2021). Cases and controls were defined by multimodal imaging. IL-4 was measured by multiplex immunoassay. Data were analyzed using a nonparametric rank based linear regression model fit to IL-4.
There were 199 patients with iAMD, 97 patients with GA, and 139 controls, with a percentage of female patients 61%, 55%, and 66%, respectively. We demonstrated significantly higher median IL-4 levels in GA (35.3; interquartile range [IQR] = 22.8-50.5) compared to iAMD (6.1; IQR = 2.2-11.3, P < 0.01) and controls (10.7; IQR = 5.0-16.8, P < 0.01). There were no significant differences in levels of IL-4 for cases and controls when stratified by sex.
These findings demonstrate a systemic immunological difference between iAMD and GA, indicating IL-4 may be a systemic biomarker for GA development.
The plasma biomarker IL-4 is significantly elevated in patients with GA.
慢性局部炎症是年龄相关性黄斑变性（AMD）发病机制的基础，会对神经感觉视网膜造成损伤。然而，针对 AMD 患者系统性细胞介导炎症的研究甚少。白细胞介素-4（IL-4）是一种免疫调节细胞因子，在调节慢性免疫介导疾病的炎症方面发挥着重要作用。本研究的目的是：（1）研究系统性 IL-4 在中间型 AMD（iAMD）和地理萎缩（GA）患者中的作用，GA 是 AMD 的一种晚期形式，并与无 AMD 的对照组进行比较；（2）确定 IL-4 水平是否受性别调节。
我们检测了科罗拉多大学 AMD 注册中心（2014 年 8 月至 2021 年 6 月）中 iAMD、GA 患者和无 AMD 对照组的血浆 IL-4 水平。病例和对照通过多模态成像定义。通过多重免疫测定法测量 IL-4。使用非参数基于秩的线性回归模型对 IL-4 进行数据分析。
共有 199 名 iAMD 患者、97 名 GA 患者和 139 名对照，女性患者的百分比分别为 61%、55%和 66%。与 iAMD（6.1；IQR=2.2-11.3，P<0.01）和对照组（10.7；IQR=5.0-16.8，P<0.01）相比，GA 患者的中位 IL-4 水平明显更高（35.3；IQR=22.8-50.5）。按性别分层时，病例和对照之间的 IL-4 水平没有差异。
这些发现表明 iAMD 和 GA 之间存在系统性免疫学差异，表明 IL-4 可能是 GA 发展的系统性生物标志物。
英文原文中的 AMD 指的是 age-related macular degeneration，中文译文统一翻译为“年龄相关性黄斑变性”。
英文原文中的 iAMD 指的是 intermediate AMD，中文译文统一翻译为“中间型 AMD”。
英文原文中的 GA 指的是 geographic atrophy，中文译文统一翻译为“地理萎缩”。
