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Abstract
Purpose
To evaluate the expression of chemokine and chemokine receptors in the aqueous humor (AH) of patients with recurrent anterior uveitis (AU) in terms of HLA-B-27-association.
Methods
Patients with endogenous uveitis were recruited from the uveitis clinic at Seoul National University Hospital. AH and peripheral blood (PB) were obtained from each patient. The expression of chemokine receptors in T-cells from AH and PB was measured using flow cytometric analysis. Interleukin (IL)-8, interferon-γ inducible protein (IP)-10, and regulated-on-expression, normal T-cell expressed and secreted (RANTES) levels of PB and AH were measured. The expression of chemokine receptor and chemokine levels in PB and AH were compared between HLA-B27-associated AU and idiopathic AU patients.
Results
Seventeen patients with HLA-B27-associated AU, 14 patients with idiopathic AU and 5 healthy controls were included in this study. IL-8 and IP-10 levels of AH were shown to be increased more than in PB, and intraocular concentrations of IL-8 and IP-10 were higher in patients with HLA-B27-associated AU than in idiopathic AU patients. RANTES levels in AH were significantly lower than in PB for all groups. In all groups, the expression of chemokine receptor in AH increased more than in PB.
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Figure 1.
Chemokine levels in the peripheral blood (PB) and the aqueous humor (AH) from patients with idiopathic and HLA-B27-associated anterior uveitis (AU). (A, B) Intraocular IL-8 and IP-10 levels in patient groups were significantly increased than those of PB. IL-8 and IP-10 levels in the aqueous humor of patients with HLA B-27-associated AU were higher than in patients with idiopathic AU ( p=0.001, Kruskal-Wallis test). (C) RANTES levels in AH were significantly lower than those in PB in all groups and were not different between the groups. RANTES levels in PB of patient groups were significantly higher than those of healthy controls, but RANTES levels in PB were not different between the patient groups.
Figure 2.
Representative dot-plot diagrams and histograms which show the expression of CXCR1, CXCR3, and CCR5 in the peripheral blood cells from patients with healthy controls, idiopathic and HLA-B27-associated anterior uveitis. (middle) The region where lymphocytes were accumulated was gated according to forward scatter and side scatter. The percentage of CD4+ and CD8+ T cells subsets among the lymphocytes were shown. The expression of CXCR1, CXCR3 and CCR5 in CD8+ (upper) and CD4+ (lower) T lymphocytes of peripheral blood samples was not different in comparisons among the groups.
Figure 3.
Representative dot-plot diagrams and histograms which show the expression of CXCR1, CXCR3, and CCR5 in the aqueous humor cells from patients with idiopathic and HLA-B27-associated anterior uveitis. (middle) The region where lymphocytes were accumulated was gated according to forward scatter and side scatter. The percentage of CD4+ and CD8+ T cells subsets among the lymphocytes were shown. The expression of CXCR1, CXCR3 and CCR5 in CD8+ (upper) and CD4+ (lower) T lymphocytes of aqueous humor samples was not different in comparisons among the groups. The surface phenotype of the cells from aqueous humor of healthy controls could not be identified because of the low cell count.
Figure 4.
The expression of chemokine receptors in patients with idiopathic and HLA-B27-associated anterior uveitis (AU). In two groups, the CD4+ T cell population in the aqueous humor (AH) was higher than that in the peripheral blood (PB). (A) In patients with idiopathic AU, the percentages of intraocular CD4+CXCR3+ and CD4+CCR5+ T cells increased than those of PB. The percentage of CD4+CCR4+ T cells in AH was lower than that in PB ( p<0.05, Wilcoxon signed rank test). In patients with HLA-B27-associated AU, the percentage of intraocular CD4+CCR5+ T cells increased than that of PB. (B) The percentage of CD8+CCR5+ T cells in AH was lower than that in PB ( p<0.05, Wilcoxon signed rank test).
Table 1.
Clinical features in patients with idiopathic and HLA-B27-associated anterior uveitis
| Idiopathic anterior uveitis (n=14) | anterior uveitis (n=17) HLA-B27-associated | p-value | |
|---|---|---|---|
| Age (years) | 38.4±17.5 | 34.8±11.3 | 0.73 |
| Sex (M:F) | 6:8 | 7:10 | 0.93* |
| Duration of uveitis (mo) | 2.4±3.2 | 2.2±2.4 | 0.71 |
| Number of patients with topical steroid at sampling | 6 | 12 | 0.12∗ |
| Systemic association | Ankylosing spondylitis: 3 | ||
| Reiter syndrome: 1 | |||
| Juvenile rheumatoid arthritis: 1 |
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