1 Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, China 2 Department of Ophthalmology, Inner Mongolia Autonomous Region People's Hospital, Hohhot 010020, China 3 Inner Mongolia Chao Ju Ophthalmologic Hospital, Hohhot 010020, China
Objective: To investigate the role of Th17, Th1 and regulatory T cell (Treg)-related pro-inflammatory cytokines on postoperative inflammation in children with juvenile idiopathic arthritis (JIA). Methods: This was a retrospective case-control study. Serum from 32 children with JIA and 35 controls with congenital cataract in Inner Mongolia Autonomous Region People's Hospital from July 2013 to March 2018 were ennolled before surgery and 1, 7, 30 and 90 days after surgery, and aqueous humor (AqH) was collected at the commencement of surgery. Protein levels of inter leukin-1 beta (IL-1β), IL-6, IL-10, IL-23, IL- 27, IL-17 and IFN-gamma in serum and AqH were determined by the multiplexed immunoassay method. A laser flare-cell photometer was used to quantify intraocular inflammation. Repeated measurements of variance was used for statistical analysis of data. A Spearman correlation coefficient test was used to evaluate the correlation between the protein levels of IL-6, IL-23, IFN-gamma in serum and AqHand intraocular inflammation in JIA patients. Results: Serum IL-1β (106±27 pg/ml), IL-6 (305±82 pg/ml), IL-10 (202±114 pg/ml), IL-23 (612±190 pg/ml), IL-27 (110±43 pg/ml) and IFN-gamma (172±43 pg/ml) levels were significantly higher in children with JIA when compared to control patients after the first day postoperatively, decreased rapidly, and attenuated gradually. AqH levels of the cytokines were below the detection level in children with JIA and controls. Notably, the following serum levels were strongly correlated with aqueous flare values in children with JIA: Serum IL-6 levels (r=0.085, P=0.002), serum IFN-gamma levels (r=0.741, P=0.021), serum IL-23 levels (r=0.622, P=0.028). Serum IL-6 levels (r=0.729, P=0.006), and serum IFN-gamma levels (r=0.669, P=0.019) correlated with aqueous cells. Serum IL-23 levels were not correlated with AqH in children with JIA (r=0.646, P=0.051). Conclusion: The increase in the number of Th17, Th1 and regulatory T cell related proinflammatory cytokines IL-6 and IFN-gamma can reflect inflammation in JIA children's eyes after surgery. Serum IL-1beta, IL-10, IL-23 and IL-27 levels can be used to evaluate postoperative intraocular inflammation.
马晓程1 邢怡桥1 姜淑红2 崔巍3. 幼年特发性关节炎患儿白内障术后眼内 炎症与血清细胞因子的关系[J]. 中华眼视光学与视觉科学杂志, 2019, 21(11): 813-819.
Xiaocheng Ma1,Yiqiao Xing1,Shuhong Jiang2,Wei Cui3. Serum Cytokine Profiles Associated with Intraocular Inflammation after Cataract Surgery in Children with Juvenile Idiopathic Arthritis. Chinese Journal of Optometry Ophthalmology and Visual science, 2019, 21(11): 813-819. DOI: 10.3760/cma.j.issn.1674-845X.2019.11.003
Eisenstein EM, Berkun Y. Diagnosis and classification of juvenile idiopathic arthritis. J Autoimmun, 2014, 48-49: 31-33. DOI: 10.1016/j.jaut.2014.01.009.
[2]
Wells JM, Smith JR. Uveitis in juvenile idiopathic arthritis: recent therapeutic advances. Ophthalmic Res, 2015, 54(3): 124- 127. DOI:10.1159/000438758.
[3]
Suelves AM, Lamba N, Meese HK, et al. Nuclear cataract as an early predictive factor for recalcitrant juvenile idiopathic arthritis-associated uveitis. J AAPOS, 2016, 20(3): 232-238. DOI: 10.1016/j.jaapos.2016.02.010.
[4]
Paroli MP, Abbouda A, Restivo L, et al. Juvenile idiopathic arthritis-associated uveitis at an Italian tertiary referral center: clinical features and complications. Ocul Immunol Inflamm, 2015, 23(1): 74-81. DOI: 10.3109/09273948.2013.855798.
[5]
Böhm MR, Tappeiner C, Breitbach MA, et al. Ocular hypotony in patients with juvenile idiopathic arthritis-associated uveitis. Am J Ophthalmol, 2017, 173: 45-55. DOI: 10.1016/j.ajo.2016. 09.018.
[6]
Calvo-Río V, Santos-Gómez M, Calvo I, et al. Anti-Interleukin-6 receptor tocilizumab for severe juvenile idiopathic arthritisassociated uveitis refractory to anti-tumor necrosis factor therapy: A multicenter study of twenty-five patients. Arthritis Rheumatol, 2017, 69(3): 668-675. DOI: 10.1002/art.39940.
[7]
Wang L, Zhang Z, Koch DD, et al. Anterior chamber interleukin 1β, interleukin 6 and prostaglandin E2 in patients undergoing femtosecond laser-assisted cataract surgery. Br J Ophthalmol, 2016, 100(4): 579-582. DOI: 10.1136/ bjophthalmol-2015-307586.
[8]
Sardar E, Dusser P, Rousseau A, et al. Retrospective study evaluating treatment decisions and outcomes of childhood uveitis not associated with juvenile idiopathic arthritis. J Pediatr, 2017, 186: 131-137. e1. DOI: 10.1016/j.jpeds.2017.03. 052.
[9]
Oray M, Khachatryan N, Ebrahimiadib N, et al. Ocular morbidities of juvenile idiopathic arthritis-associated uveitis in adulthood: Results from a tertiary center study. Graefes Arch Clin Exp Ophthalmol, 2016, 254(9): 1841-1849. DOI: 10.1007/ s00417-016-3340-z.
[10]
Cosmi L, Cimaz R, Maggi L, et al. Evidence of the transient nature of the Th17 phenotype of CD4+CD161+ T cells in the synovial fluid of patients with juvenile idiopathic arthritis. Arthritis Rheum, 2011, 63(8): 2504-2515. DOI: 10.1002/art. 30332.
[11]
Tappeiner C, Klotsche J, Schenck S, et al. Temporal change in prevalence and complications of uveitis associated with juvenile idiopathic arthritis: Data from a cross-sectional analysis of a prospective nationwide study. Clin Exp Rheumatol, 2015, 33(6): 936-944.
[12]
Jiang S, Liu X, Luo L, et al. Serum levels of Th17-related cytokines in Behcet disease patients after cataract surgery. Mol Vis, 2011, 17: 1425-1430. DOI: 10.3109/13816810.2010. 544361.
[13]
Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: Second revision, Edmonton, 2001. J Rheumatol, 2004, 31(2): 390-392. DOI: 10.1021/ic50115a029.
[14]
Drozdova EA, Yadykina EV, Mezentseva EA, et al. Cytokine profile changes in children with juvenile idiopathic arthritisassociated uveitis. Vestn Oftalmol, 2017, 133(1): 27-31. DOI: 10.17116/oftalma2017133127-31.
[15]
Giles K, Christelle D, Yannick B, et al. Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications. Pan Afr Med J, 2016, 24: 200. DOI: 10.11604/pamj.2016.24.200.9771.
[16]
Fan DS, Tang EW, Rao SK, et al. The use of peribulbar anaesthesia in paediatric cataract surgery (age 7-15 years) in a mobile eye camp in China. Acta Ophthalmol Scand, 2006, 84(3): 384-387. DOI: 10.1111/j.1600-0420.2005.00599.x.
[17]
周扬. 炎性细胞因子在全身型幼年特发性关节炎中的临床意义. 西安: 西安医学院, 2018.
[18]
Mahendra A, Misra R, Aggarwal A. Th1 and Th17 Predominance in the enthesitis-related arthritis form of juvenile idiopathic arthritis. J Rheumatol, 2009, 36(8): 1730-1736. DOI: 10.3899/jrheum.081179.
[19]
Lee YS, Amadi-Obi A, Yu CR, et al. Retinal cells suppress intraocular inflammation (uveitis) through production of interleukin-27 and interleukin-10. Immunology, 2011, 132(4): 492-502. DOI: 10.1111/j.1365-2567.2010.03379.x.
[20]
de Kleer IM, Wedderburn LR, Taams LS, et al. CD4+CD25 bright regulatory T cells actively regulate inflammation in the joints of patients with the remitting form of juvenile idiopathicarthritis. J Immunol, 2004, 172(10): 6435-6443. DOI: 10.4049/ jimmunol.172.10.6435.
[21]
de Kleer IM, Kamphuis SM, Rijkers GT, et al. The spontaneous remission of juvenile idiopathic arthritis is characterized by CD30+ T cells directed to human heat-shock protein 60 capable of producing the regulatory cytokineinterleukin-10. Arthritis Rheum, 2003, 48(7): 2001-2010. DOI: 10.1002/art.11174.
[22]
Banerjee S, Savant V, Scott RA, et al. Multiplex bead analysis of vitreous humor of patients with vitreoretinal disorders. Invest Ophthalmol Vis Sci, 2007, 48(5): 2203-2207. DOI: 10.1167/ iovs.06-1358.
[23]
Tu KL, Kaye SB, Sidaras G, et al. Effect of intraocular surgery and ketamine on aqueous and serum cytokines. Mol Vis, 2007, 13: 1130-1137. DOI: 10.1016/j.visres.2007.06.007.
[24]
Wallace GR, Farmer I, Church A, et al. Serum levels of chemokines correlate with disease activity in patients with retinal vasculitis. ImmunolLett, 2003, 90(1): 59-64. DOI: 10. 1016/s0165-2478(03)00159-7.
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