开角型青光眼患者外周血细胞因子与视神经损伤关系的研究

Relationship of cytokines levels and optic nerve damage in open-angle glaucoma patients

目的比较原发性开角型青光眼患者与正常对照组血清中sIL-2R、IL-2、IL-4、IL-6、IL-12、IFNγ(interferon-gamma)的水平差异;观察这些细胞因子在原发性开角型青光眼患者视神经损伤不同阶段浓度的变化。方法采用双抗体夹心酶联免疫吸附法(ELISA)测定外周血中sIL-2R、IL-2、IL-4、IL-6、IL-12、IFNγ质量浓度水平。青光眼组患者损伤较重眼,共82眼按视野损伤程度分为轻中重三组,比较各细胞因子在三组间质量浓度的差异。结果青光眼组患者血清中sIL-2R和IL-4显著高于对照组(P=0.045,P=0.030);IL-6和IL-12显著低于对照组(P=0.011,P=0.000);IL-2和IFNγ的血清水平在青光眼和对照组两组间差异无统计学意义(P=0.956,P=0.138)。轻度视神经损伤组sIL-2R的血清浓度(69.519±25.557)显著低于重度损伤组(89.462±24.051)(P=0.018);而IL-12的血清浓度(113.097±43.309)显著高于重度损伤组(81.816±43.814)(P=0.025)。结论原发性开角型青光眼患者机体内参与细胞免疫的细胞因子水平不同于正常人,且有些细胞因子质量浓度与视神经损伤程度相关。

Objective Researches proved that the apoptosis of retinal ganglion cells is a vital pathway to cause optic neuropathy in primary open-angle glaucoma（POAG） ,while many cytokines were responsible for cell apoptosis. The present study was to investigate the relationship of sIL-2R, IL-2, IL-4, IL-6, IL-12 and IFN± levels in serum to different stages of glaucomatous neuropathy in POAG patients. Methods In this study,82 patients with POAG（glaucoma group） and 29 normal individuals（control group） were collected. Eighty-two eyes of 82 POAG were divided into 3 groups according to the mean defect （MD） of visual fields （ group A ： MD 〈 6 dB ; group B： 6 dB≤MD 〈 12 dB; group C： MD≥12 dB）. Cytokines such as sIL-2R,IL-2,IL-4,IL-6,IL-12 and IFNγ in serum were assayed by Enzyme-linked immunosorbent assay （ELISA） and the mean concentrations of these factors in different groups were analyzed and compared. Results The levels of sIL-2R and IL-4 in glaucoma group were significantly elevated in comparison with control group （ t = 2. 084,P = 0. 045 ; t = 2. 229, P = 0. 030, respectively） ; the levels of IL-6 and IL-12 in serum were reduced in glaucoma patients compared with normal individuals （ t = - 2. 640, P = 0. 011 ; t = - 4. 05 ,P = 0. 000, respectively ）. There were no significant differences in IL-2 and IFNγ serum concentrations between two groups（ t = 0. 055 ,P = 0. 956 ;t = -1. 517 ,P = 0. 138 ,respectively）. In POAG patients, the level of sIL-2R in group A（69.519 ±25.557 pg/ml） was significantly lower than that in group C（89.452 ±24.051 pg/ml） （P = 0. 018） ,and the concentration of IL-12 in group A（ 113. 097 ±43. 309 pg/ml） was significantly higher than that in group C（81. 816 ± 43. 814 pg/ml）（P = 0. 025 ）. However, no statistical significant differences were found in other cytokines among the different stage of diseases. Conclusion Cellular immune system may be different in POAG patients from normal person. Cytokines such as sIL-2R ,IL- 2,IL-4,IL-6,IL-12 may be associated with glaucomatous optic neuropathy.