Clinical And Serum Immunology Research Of Uveitis

Objective:1. To observe the clinical features, the complications and treatment effects of uveitis.2. To compare the concentrations of tumor necrosis factor alpha (TNF alpha), interleukin10(IL-10) and interleukin17(IL-17) in serum samples from uveitis (anterior uveitis, intermediate uveitis and panuveitis) patients and normal control group.3. To determine the role of TNF-a, IL-10and IL-17in the pathogenesis of uveitis and to find new treatments.Methods:A series of65patients with uveitis and25healthy persons from our hospital from November2012to May2013were investigated. The cases with uveitis included35males and30females. The age of cases ranged from8to67years, and the mean age was39.51±13.26years. Among the patients with uveitis,35patients with anterior uveitis included17males and18females, and the mean age was38.66±12.11years.8patients with intermediate uveitis included5males and3females, and the mean age was37.25±14.92years.22patients with panuveitis included13males and9females, and the mean age was41.68±14.69years. Among the panuveitis there are8patients with Vogt-Koyanagi-Harada syndrome included4males and4females, and the mean age was48.88±6.64years.4patients with Behcet’s disease included3males and1females, and the mean age was30.75±17.65years. With early treatment diabetic retinopathy research team "E" word eye chart measure far vision. All patients in the specialized state by slit-lamp microscope, direct ophthalmoscope and fluorescein fundus blood vessel according to inspection for diagnosis and staging. Patients measure the serum of antistreptolysin O test, rheumatoid factor, antinuclear antibody and immunological tests. All cases were graded by the classification by the International Uveitis Study Group. In the same period the patients without uveitis collected25cases as control group, included13males and12females, the age of cases ranged from7to65years, and the mean age was45.04±17.41years.25controls who without any history of disease, all the recent not taking antibiotics and corticosteroids or other immune inhibitors were selected into this study. All samples were stored in eppendorf tube at-20℃immediately after obtained. The concentrations of TNF-a, IL-10, IL-17serum samples were measured by enzyme-linked immunosobent assay(ELISA). All data were analyzed with SPSS17.0and concentrations of TNF-a, IL-10, IL-17, the mean age were represented by (mean±standard deviation). The data was coincidence with gauss distribution tested and by Shapiro-Wilk test and the data were regular tested with homogeneity test for variance. The t test and chi-square test were used respectively to compare differences between the two groups of age and gender, F test of variance analysis use to analyze the differences in serum levels of cytokines. Spearman correlation analysis is used to analyze all kinds of relationship between cytokines. The difference was considered with significance when P<0.05.Results:1. The age of cases ranged from8to67years, peak age is around25-44. Gender ratio is1.17for male to female. Anterior uveitis is the most common type. There are26cases with a definite etiology.39cases belong to the idiopathic uveitis. In total65cases,28cases experienced variable complications. There is a7.7%chance leading to blind. After appropriate treatment, most of the patient can get visual function improved.2. The means of TNF-α、IL-10and IL-17concentrations in serum from cases were17.37±12.65pg/ml,68.05±11.74pg/ml and48.61±35.89pg/ml respectively. The mean of TNF-α, IL-10and IL-17concentrations in serum from controls were26.33±12.28pg/ml,72.00±129.03pg/ml and25.06±28.24pg/ml respectively. The difference of TNF-a, IL-17concentrations of serum was statistically significant between cases and controls, IL-10concentrations of serum was not significant difference between cases and controls (TNF-a:F=9.188/P=0.003; IL-10:P=0.988; IL-17:P=0.000).3. The means of TNF-a, IL-10and IL-17concentrations in serum from activity cases were17.99±12.75pg/ml,79.15±118.93pg/ml and58.01±41.72pg/ml respectively. The mean of TNF-a, IL-10和IL-17concentrations in serum from plateau cases were14.33±12.24pg/ml,13.54±31.82pg/ml and46.18±39.06pg/ml respectively. TNF-α, IL-10and IL-17concentrations of serum was no difference between activity cases and plateau cases (TNF-a:F=0.762/P=0.386; IL-10:P=0.108; IL-17:P=0.270).4. The means of TNF-α, IL-10and IL-17concentrations in serum from anterior uveitis were18.56±13.38pg/ml,80.10±13.94pg/ml,64.40±42.76pg/ml respectively. The means of TNF-α, IL-10and IL-17concentrations in serum from intermediate uveitis were8.41±4.14pg/ml,61.05±126.74pg/ml,46.81±36.70pg/ml respectively. The means of TNF-α, IL-10and IL-17concentrations in serum from panuveitis were18.75±12.40pg/ml,51.43±105.49pg/ml and46.01±38.95pg/ml respectively. TNF-a, IL-10and IL-17concentrations of serum was no difference between three groups(TNF-α:F=2.393/P=0.100; IL-10:P=0.550; IL-17:P=0.410).5. Analysis by Spearman correlation test, IL-17was positively related with disease (Spearman correlation coefficient:r=0.371, P=0.000), TNF-a was negatively correlated with disease (Spearman correlation coefficient:r=0.301, P=0.004).Conclusion:1. Uveitis is popular in the young and middle-aged population, a group of common eye disease and is one of blindness worldwide. Anterior uveitis is the most common type. Corticosteroids and immunosuppressive agents are commonly used for the treatment of uveitis. However, long-tenn application of these drugs frequently lead to numerous side effects. Therefore, to find new treatments becomes inevitable.2. IL-17in the serum from uveitis patients increased compared with controls. IL-17is an important cytokine of uveitis. Th17cells may participate in uveitis pathogenesis.3. IL-10in the serum concentration from uveitis patients and controls have no difference, the serum IL-10of majority of patients concentration is too low to be detected.4. TNF-α in the serum from uveitis patients decreased compared with controls. Inhibition of concentration of TNF-a will cause uveitis and deterioration.