交感性眼炎患者房水和血清细胞因子水平的分析

Cytokine analysis in the aqueous humor and serum of patients with sympathetic ophthalmia

目的 检测交感性眼炎急性发作期患者房水和血清细胞因子的水平。方法 选取2009年1月～2011年12月在我院眼科就诊的交感性眼炎急性发作期的患者15例，前房穿刺取患者房水，同时取患者静脉血，收集血清标本。以年龄相关性白内障患者术前血清标本和术中房水作对照。应用酶联免疫吸附试验（ELISA）分析交感性眼炎急性发作期患者及白内障患者房水及血清中IFN-γ（Th1细胞分泌因子）、IL-4（Th2细胞分泌因子）和IL-17（Th17细胞分泌因子）细胞因子水平。结果 交感性眼炎急性发作期患者的房水IFN-γ水平与血清中IFN-γ的水平相比明显升高，分别为（148.1±57.9）pg/mL、（6.5±5.4）pg/mL，差异有统计学意义（P〈0.01）；房水IL-4水平与血清中IL-4的水平相比差异有统计学意义（P〈0.01），分别为（2.3±3.5）pg/mL、（8.9±5.0）pg/mL，交感性眼炎患者房水中IL-4水平明显低于血清；房水IL-17水平和血清 IL-17水平相比差异有统计学意义（P〈0.01），分别为（48.3±21.6）pg/mL、（6.5±9.6）pg/mL，房水中IL-17水平明显高于血清。交感性眼炎急性发作期患者房水和血清IFN-γ水平与对照组房水和血清IFN-γ水平相比均明显升高（P〈0.01，P〈0.05）；交感性眼炎患者房水和血清IL-4水平与对照组房水和血清IL-4水平相比差异无统计学意义（P〉0.05，P〉0.05）；对照组房水和血清 IL-17水平均未测出。结论 交感性眼炎患者眼部炎症的发病主要是与Th1和Th17细胞分泌因子IFN-γ和IL-17有关，对于炎症的防治有指导意义。

Cytokine analysis in the aqueous humor and serum of patients with sympathetic ophthalmia Objective To detect the cytokine levels in the aqueous humor （AqH） and serum from patients with active sympathetic ophthalmia. Methods AqH and peripheral blood samples were collected from 15 patients with active sympathetic ophthalmia who were first diagnosed in our hospital during Jan 2009 to Dec 2011. 15 healthy subjects underwent age-related cataract surgery were obtained as controls. AqH was collected during surgery from patients with age-related cataract as control specimens. Serum were collected before surgery. Cytokine levels of serum and AqH including interferon gamma （IFN-γ）, interleukin （IL）-4 and IL-17 were measured by enzyme-linked immunosorbent assay （ELISA） and compared between the two groups. Results IFN-γ levels were significantly higher in AqH of active sympathetic ophthalmia patients as compared with the serum specimen（148.1±57.9 pg/mL and 6.5±5.4 pg/mL, P〈0.01）. IL-4 levels were significantly lower in AqH of active sympathetic ophthalmia patients as compared with the serum specimen（2.3±3.5 pg/mL and 8.9±5.0 pg/mL, P〈0.01）. IL-17 levels were significantly higher in the AqH of active sympathetic ophthalmia patients as compared with the serum specimen（48.3±21.6 pg/mL and 6.5±9.6 pg/mL, P〈0.01）. IFN-γ levels in the AqH and serum of active sympathetic ophthalmia patients were significantly higher than those in controls（P〈0.01,P〈0.05）. IL-4 levels in the AqH and serum of active sympathetic ophthalmia patients showed no significant differences as compared with those in controls（P〉0.05）. IL-17 levels in the AqH and serum of control patients were not detectable. Conclusions Pathogenesis of active sympathetic ophthalmia is correlated with IFN-γ （Th1 cytokine） and IL-17 （Th17 cytokine）. These can be useful in the prevention and treatment of sympathetic ophthalmia.