Different Composition of Intraocular Immune Mediators in Posner-Schlossman-Syndrome and Fuchs' Uveitis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 Jun 27

PMID 29944680

Citations 17

Authors

Dominika Pohlmann

Stephan Schlickeiser

Sylvia Metzner

Matthias Lenglinger

Sibylle Winterhalter

Uwe Pleyer

Affiliations

Soon will be listed here.

Abstract

Posner-Schlossman-Syndrome (PSS) is clinically characterized by acute, recurrent, mild, unilateral uveitis anterior accompanied by elevated intraocular pressure (IOP). Fuchs´ Uveitis (FU) is a chronic, low-grade-inflammatory disorder, involving anterior uvea and vitreous. The clinical findings show remarkable similarities as well as differences. In our study, we determine the composition of immune mediators in aqueous humor of patients with PSS and FU and evaluate if immune mediators play a crucial role in specific viral intraocular inflammation and IOP rises. Aqueous humor samples from 81 uveitis patients (= eyes) presenting with either PSS or FU were collected at one time point. Local intraocular antibody synthesis to rubella virus was confirmed in 65 patients, whereas 16 were tested positively for human cytomegalovirus. Thirteen patients with PSS and 10 patients with FU were treated with glaucoma medications. Additionally, 11 cataract patients acted as control group. Immune mediator concentrations were measured by Bio-Plex Pro assay. We observed in both PSS (IFN-γ: 174.9 pg/mL; TNF-α: 25.1 pg/mL) and FU (IFN-γ: 25.4 pg/mL; TNF-α: 27.2 pg/mL) groups a significantly increased level of T-helper 1 immune mediators compared to controls (IFN-γ, TNF-α: 0 pg/mL) [median]. Notably, PSS patients (IL-1RA: 73.4 pg/mL; IL-8: 199.4 pg/mL; IL-10: 33.4 pg/mL; IP-10: 126350 pg/mL) showed a stronger and more active ocular inflammatory response, than FU patients (IL-1RA: 4.3 pg/mL; IL-8: 72.4 pg/mL; IL-10: 1.6 pg/mL; IP-10: 57400 pg/mL). Furthermore, a negative correlation between mediators and IOP was seen in the PSS group, potentially caused by acetazolamide-treatment. Our findings show that immune mediators play a crucial role in specific viral intraocular inflammation and influence IOP levels. Remarkable similarities but also significant differences of immune mediator concentrations are apparent in PSS compared to FU. High concentrations of IL-1RA, IL-8, IL-10, and IP-10 correlate with active inflammation in PSS, while FU may trigger chronic inflammation. Our data also substantiated a very similar composition of cytokines in those patients from the PSS group suffering from ocular hypertension and thus offers a potential explanation model for a negative correlation between mediators and IOP.

Citing Articles

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Escribano Lopez P, Gonzalez Guijarro J Graefes Arch Clin Exp Ophthalmol. 2025; .

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Selective Upregulation of Interleukin 1 Receptor Antagonist and Interleukin-8 in Fuchs' Endothelial Corneal Dystrophy with Accompanying Cataract.

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Features of hemodynamic and immunological parameters in patients with recurrent uveitis complicated by hypertension, Fuchs heterochromic uveitis and Posner-Schlossman syndrome.

Khramenko N, Velychko L, Konovalova N, Bogdanova O, Gheorghe L, Bobescu D Rom J Ophthalmol. 2023; 67(1):20-32.

PMID: 37089809 PMC: 10117184. DOI: 10.22336/rjo.2023.5.

Clinical Characteristics of Posner-Schlossman Syndrome Patients in China.

Gao T, Song S, Ke X, Li S, Zhang D, Chen X Biomed Res Int. 2023; 2023:4110344.

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Posner-Schlossman syndrome relapse following inactivated COVID-19 vaccination in China.

Sheng Q, Sun Y, Zhai R, Fan X, Ying Y, Kong X Front Public Health. 2023; 10:1051378.

PMID: 36711335 PMC: 9880426. DOI: 10.3389/fpubh.2022.1051378.

References

Schwaighofer H, Oberhuber G, Hebart H, Einsele H, Herold M, Nachbaur D . Endogenous interleukin 1 receptor antagonist during human bone marrow transplantation: increased levels during graft-versus-host disease, during infectious complications, and after immunoglobulin therapy. Transplantation. 1997; 63(1):52-6. DOI: 10.1097/00007890-199701150-00010. View

Suzuki J, Goto H, Komase K, Abo H, Fujii K, Otsuki N . Rubella virus as a possible etiological agent of Fuchs heterochromic iridocyclitis. Graefes Arch Clin Exp Ophthalmol. 2010; 248(10):1487-91. DOI: 10.1007/s00417-010-1434-6. View

Sijssens K, Rijkers G, Rothova A, Stilma J, Schellekens P, de Boer J . Cytokines, chemokines and soluble adhesion molecules in aqueous humor of children with uveitis. Exp Eye Res. 2007; 85(4):443-9. DOI: 10.1016/j.exer.2007.06.011. View

Wang C, Wang R, Xie H, Sun Y, Tao R, Liu W . Effect of acetazolamide on cytokines in rats exposed to high altitude. Cytokine. 2016; 83:110-117. DOI: 10.1016/j.cyto.2016.04.003. View

Jabs D, Nussenblatt R, Rosenbaum J . Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005; 140(3):509-16. PMC: 8935739. DOI: 10.1016/j.ajo.2005.03.057. View

Murray P, Hoekzema R, Van Haren M, de Hon F, Kijlstra A . Aqueous humor interleukin-6 levels in uveitis. Invest Ophthalmol Vis Sci. 1990; 31(5):917-20. View

Zhao B, Chen W, Jiang R, Zhang R, Wang Y, Wang L . Expression profile of IL-1 family cytokines in aqueous humor and sera of patients with HLA-B27 associated anterior uveitis and idiopathic anterior uveitis. Exp Eye Res. 2015; 138:80-6. DOI: 10.1016/j.exer.2015.06.018. View

Koizumi N, Inatomi T, Suzuki T, Shiraishi A, Ohashi Y, Kandori M . Clinical features and management of cytomegalovirus corneal endotheliitis: analysis of 106 cases from the Japan corneal endotheliitis study. Br J Ophthalmol. 2014; 99(1):54-8. PMC: 4283688. DOI: 10.1136/bjophthalmol-2013-304625. View

Stunf S, Petrovec M, Zigon N, Hawlina M, Kraut A, De Groot-Mijnes J . High concordance of intraocular antibody synthesis against the rubella virus and Fuchs heterochromic uveitis syndrome in Slovenia. Mol Vis. 2012; 18:2909-14. PMC: 3519374. View

10.

Lahmar I, Abou-Bacar A, Abdelrahman T, Guinard M, Babba H, Ben Yahia S . Cytokine profiles in toxoplasmic and viral uveitis. J Infect Dis. 2009; 199(8):1239-49. DOI: 10.1086/597478. View

11.

Posner A, SCHLOSSMAN A . Syndrome of unilateral recurrent attacks of glaucoma with cyclitic symptoms. Arch Ophthal. 1948; 39(4):517-35. DOI: 10.1001/archopht.1948.00900020525007. View

12.

de-la-Torre A, Pfaff A, Grigg M, Villard O, Candolfi E, Gomez-Marin J . Ocular cytokinome is linked to clinical characteristics in ocular toxoplasmosis. Cytokine. 2014; 68(1):23-31. PMC: 4889015. DOI: 10.1016/j.cyto.2014.03.005. View

13.

Ruokonen P, Metzner S, Ucer A, Torun N, Hofmann J, Pleyer U . Intraocular antibody synthesis against rubella virus and other microorganisms in Fuchs' heterochromic cyclitis. Graefes Arch Clin Exp Ophthalmol. 2009; 248(4):565-71. DOI: 10.1007/s00417-009-1239-7. View

14.

Li J, Ang M, Cheung C, Vania M, Chan A, Waduthantri S . Aqueous cytokine changes associated with Posner-Schlossman syndrome with and without human cytomegalovirus. PLoS One. 2012; 7(9):e44453. PMC: 3441587. DOI: 10.1371/journal.pone.0044453. View

15.

Carlyn C, Andersen N, Baltch A, Smith R, Reilly A, Lawrence D . Analysis of septic biomarker patterns: prognostic value in predicting septic state. Diagn Microbiol Infect Dis. 2015; 83(3):312-8. DOI: 10.1016/j.diagmicrobio.2015.07.003. View

16.

De Groot-Mijnes J, de Visser L, Zuurveen S, Martinus R, Volker R, Ten Dam-van Loon N . Identification of new pathogens in the intraocular fluid of patients with uveitis. Am J Ophthalmol. 2010; 150(5):628-36. PMC: 7093850. DOI: 10.1016/j.ajo.2010.05.015. View

17.

Richardson T, Hutchinson B, GRANT W . The outflow tract in pigmentary glaucoma: a light and electron microscopic study. Arch Ophthalmol. 1977; 95(6):1015-25. DOI: 10.1001/archopht.1977.04450060101010. View

18.

Curnow S, Falciani F, Durrani O, Cheung C, Ross E, Wloka K . Multiplex bead immunoassay analysis of aqueous humor reveals distinct cytokine profiles in uveitis. Invest Ophthalmol Vis Sci. 2005; 46(11):4251-9. DOI: 10.1167/iovs.05-0444. View

19.

Lacomba M, Martin C, Chamond R, Galera J, Omar M, Estevez E . Aqueous and serum interferon gamma, interleukin (IL) 2, IL-4, and IL-10 in patients with uveitis. Arch Ophthalmol. 2000; 118(6):768-72. DOI: 10.1001/archopht.118.6.768. View

20.

Roth M, Simmons R . Glaucoma associated with precipitates on the trabecular meshwork. Ophthalmology. 1979; 86(9):1613-9. DOI: 10.1016/s0161-6420(79)35357-x. View