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C. P. Juarez, J. C. Muiño, M. Romero, M. Ferrero, G. Rabinovich, J. D. Luna; Disease Progression Markers in Uveitis: The Importance of Autoantibodies to Retinal S Antigen to Galectine-1, and Slpi Serum Levels. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5184.
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To compare the presence of auto-antibodies to retinal S antigen and Gal-1, and SLPI serum levels in patients with uveitis, and to evaluate their potential role for disease progression.
247 patients from our uveitis clinic were prospectively evaluated, over the past 3 years with ELISA, for the presence of IgG, IgE and IgA titers against retinal S antigen and galectine-1, as well as serum SLPI levels. Disease progression was analyzed in good and bad prognosis according to their clinical evolution and response to treatment. The patients were divided in a) Autoimmune (AIU) (n: 200) and b) Infectious uveitis (n: 47). The last group was subdivided in: Bacterial endophtalmitis (BE) (n: 32), Tuberculosis uveitis (TB U) (n: 7) and Toxoplasmic uveitis Tx U (n: 8). In 64 patients (49 AI, and 6 BE, 5 TBU, 4 Tx U) circulating IgG, IgA and IgE to Gal - 1, were determined; and in 45 patients (30 AI, 6 BE, 5 TB U, 4 TxU) SLPI levels were determined. Selected age match controls were used in all cases.
In AIU (n: 200), IgG to retinal S Ag in 73 cases, IgE to Retinal S Ag in 25 and 88 cases overlapped IgG and IgE anti retinal S Ag, 4 cases were negative to both antibodies, in BE as well as TB U all cases presented IgG and IgE negative to Retinal S Ag, the Tx U presented in 8 of 8 IgG (+) and 6 of 8 IgE to retinal S antigen, the group ( c ) presented 1 of 30 cases IgG to retinal S Ag ; p <0.00001. The circulating IgG to Gal - 1 was positive in 17 of 49 in AIU, IgE to Gal - 1 in 12 cases, IgA anti Gal - 1 in 8 cases , IgG / IgE anti Gal - 1 overlapped 12 cases. In infectious conditions (BE, TB U) were negative in all cases, the Toxoplasmic sub group presented IgG anti Gal 1 in 4 cases and IgE in 3 cases, the group (c 1 ) presented negative IgG/IgA/IgE to Gal - 1, p< 0.003 . The presence of specific IgG and in special IgE to Gal - 1 is associated with poor evolution in AIU, and the specific IgA anti Gal - 1 is associated with benign outcome. The SLPI level was in Active Autoimmune Uveitis: 457, 3 ± 50, 5 pg/ml, en Inactive Autoimmune Uveitis was: 317 ± 21, 3 pg/ml, BE was 280 ± 82.8 pg/ml, TB U: 265 ± 24 pg/ml, Tx U was: 371, 2 ± 28, 4 pg /ml and control group 303± 25 pg/ml, p< 0.0001.
The presence of IgE and IgG to retinal S antigen are associated with autoimmune uveitis and Tx U, these features suggest Th 2 activation. The IgE and IgG anti Gal - 1 are associated with poor evolution and IgA anti Gal - 1 with benign outcome. The increase of serum SLPI levels are linked with active autoimmune uveitis. as well as with Tx U, probably representing an innate and adaptative immunologic responses.
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