细胞因子与趋化因子在葡萄膜炎和黄斑囊样水肿患者房水中的表达

Purpose:To investigate the global cytokine and chemokine expression pattern in the aqueous humor of uveitis patients and relate them to clinical features.Design:Cross-sectional study.Methods:In 31 aqueous humor samples from uveitis patients,the concentration of mediators was measured by a multiplex immunoassay.Eleven control samples were included.Results:Uveitis samples had higher levels of interleukin-6,interleukin-8,soluble intercellular adhesion molecule,soluble vascular cell adhesion molecule(sVCAM),and interferon-inducible protein-10(IP-10)than nonuveitis controls.Active uveitis samples had higher levels of interleukin-6,interleukin-10,interferon-γ,sVCAM,regulated on activation,normal T cell expressed and secreted(RANTES),and IP-10 than quiescent uveitis samples.Infectious uveitis was associated with higher levels of interleukin-10 than noninfectious uveitis(P<.03 for all subgroups).No significant differences were found between cystoid macular edema(CME)and non-CME samples.Conclusions:Elevated levels of specific mediators were found in active and in infectious uveitis,but not in CME.Mediator profiles might lead to a better understanding of the pathogenesis of uveitis.

微量白蛋白尿与炎性囊样黄斑水肿

To assess the role of cardiovascular morbidity, its risk factors, and microalb uminuria in the development of inflammatory cystoid macular edema (CME). A match ed case-control study. study population: We included 24 consecutive patients wi th uveitis and CME. Twenty four uveitis patients without CME, matched for age an d duration of uveitis served as controls. intervention and observation procedure s: Patients and controls were interviewed for the presence of cardiovascular ris k factors and cardiovascular morbidity. All medications were registered. Morning urinary albumin concentration was measured, as well as blood pressure, C-react ive protein, and creatinine in blood. Patients suffering from diabetes mellitus were excluded from this study. main outcome measures: The presence of cardiovasc ular morbidity and its risk factors and microalbuminuria in uveitis patients wit h and without CME. We found a positive association between trace-and/or microal buminuria and inflammatory CME (P=. 001; odds ratio 13.0, 95%CI 2.5 to 68.1 and P=. 015; odds ratio 5.9, 95%CI 1.6 to 22.6), but no relation between CME and c ardiovascular morbidity or its risk factors. No additional association between t race-and/or any microalbuminuria and general characteristics of patients, speci fic factors related to general disease as a cause of ocular inflammation, locati on of uveitis, duration of uveitis, and medication was found. The presence of tr ace-and/or microalbuminuria in inflammatory CME might indicate the presence of early systemic vascular disease and carry the risk of developing CME. This findi ng brings new insight into the pathogenesis of CME and could open up new avenues for the treatment of CME.

一个有关赖诺普利治疗炎症性黄斑水肿的随机、双盲、交叉试验研究

PURPOSE: To analyze the effect of angiotensin-converting enzyme (ACE) inhibitor lisinopril on inflammatory cystoid macular edema and visual acuity. DESIGN: Randomized, double-blind, placebo-controlled cross-over trial. METHODS: setting: Outpatient clinic of the Department of Ophthalmology at the University Medical Center of Utrecht. Patients: Forty patients with inflammatory cystoid macular edema were included. intervention: Each patient received lisinopril (10 mg daily) or placebo for three months. After two months of a lisinopril/placebo free wash-out period, the groups received the reverse study medication for three months. Fluorescein angiography was performed to evaluate the retina. main outcome measures: Cystoid macular edema, best-corrected visual acuity and contrast sensitivity. RESULTS: Lisinopril had no effect on cystoid macular edema, visual acuity, papillary leakage, retinal vasculitis, and choroidal leakage. In a subgroup analysis, we observed a decrease in blood pressure (lisinopril, 14 of 36 patients; placebo, 5 of 36 patients; P=.02) and a decrease in morning urinary albumin excretion (lisinopril, 23 of 35 patients; placebo 10 of 34 patients, P=.003) was observed. CONCLUSIONS: Although lisinopril had no effect on inflammatory cystoid macular edema and visual acuity, we found a positive effect on the vascular system.