Vestnik oftalmologii · 2024
[Results of clinical and immunomorphological analysis in chronic post-traumatic uveitis].
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Filatova I A, Balatskaya N V, Kulikova I G, Shemetov S A, Denisyuk V O
Аннотация
PURPOSE: This study was conducted to identify the group at highest risk for autoimmune inflammation through a comparative analysis among patients with chronic post-traumatic uveitis (CPTU).
MATERIAL AND METHODS: The clinical group included 50 patients (aged 18 to 87 years, mean age 41±2.6 years) with CPTU resulting from penetrating injury, contusion, or intraocular surgery. All patients underwent comprehensive clinical and diagnostic evaluation, including immunological assessments: leukocyte migration inhibition test (LMIT), analysis of lymphocyte subpopulation composition, and cytokine profile analysis in both blood serum (BS) and aqueous humor (AH).
UNLABELLED: All patients underwent removal of the blind, non-functional eye with formation of a support-motor stump, followed by morphological examination.
UNLABELLED: Patients were divided into four groups based on the presence of immune inflammation, confirmed by morphological analysis, as well as organ-specific sensitization to ocular tissue antigens. Group 1 - histology+, LMIT+ (n=36); group 2 - histology+, LMIT- (n=50); group 3 - histology-, LMIT+ (n=12); group 4 - histology-, LMIT- (n=52). The control group consisted of 30 individuals without ocular pathology, matched by sex and age to the main patient groups.
RESULTS: In long-term CPTU, statistically significant alterations in major regulatory subpopulations were observed in group 1, with immune inflammation and a positive LMIT. The findings were confirmed in comparisons with both the control group and across study groups.
CONCLUSION: The clinical and immunomorphological analysis identified an association between decreased levels of transforming growth factor β1 (TGF-β1) in AH and its increased levels in BS, with the risk of autoimmune inflammation in CPTU. The observed changes in the local and systemic cytokine status - reduction of TGF-β1 in AH and increase in BS - may serve as early predictors of autoimmune inflammation, which is important in clinical practice for preventing sympathetic ophthalmia.
MATERIAL AND METHODS: The clinical group included 50 patients (aged 18 to 87 years, mean age 41±2.6 years) with CPTU resulting from penetrating injury, contusion, or intraocular surgery. All patients underwent comprehensive clinical and diagnostic evaluation, including immunological assessments: leukocyte migration inhibition test (LMIT), analysis of lymphocyte subpopulation composition, and cytokine profile analysis in both blood serum (BS) and aqueous humor (AH).
UNLABELLED: All patients underwent removal of the blind, non-functional eye with formation of a support-motor stump, followed by morphological examination.
UNLABELLED: Patients were divided into four groups based on the presence of immune inflammation, confirmed by morphological analysis, as well as organ-specific sensitization to ocular tissue antigens. Group 1 - histology+, LMIT+ (n=36); group 2 - histology+, LMIT- (n=50); group 3 - histology-, LMIT+ (n=12); group 4 - histology-, LMIT- (n=52). The control group consisted of 30 individuals without ocular pathology, matched by sex and age to the main patient groups.
RESULTS: In long-term CPTU, statistically significant alterations in major regulatory subpopulations were observed in group 1, with immune inflammation and a positive LMIT. The findings were confirmed in comparisons with both the control group and across study groups.
CONCLUSION: The clinical and immunomorphological analysis identified an association between decreased levels of transforming growth factor β1 (TGF-β1) in AH and its increased levels in BS, with the risk of autoimmune inflammation in CPTU. The observed changes in the local and systemic cytokine status - reduction of TGF-β1 in AH and increase in BS - may serve as early predictors of autoimmune inflammation, which is important in clinical practice for preventing sympathetic ophthalmia.