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L. Trinh, F. Brignole–Baudouin, S. Dupont–Monod, N. Cassoux, P. LeHoang, C. Baudouin; CCR4 and CCR5 Expression From Conjunctival Impression Cytology Specimens of Patients With Uveitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4515.
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To investigate CCR4 and CCR5 expressions, known to be related to the TH2 and TH1 inflammatory pathways respectively, and HLA DR antigens, as a hallmark for inflammatory reactions, on the ocular surface of patients with uveitis using conjunctival impression cytology specimens.
Conjunctival impression cytology specimens were taken in a series of patients presenting with uveitis (n = 16), and compared with specimens from vernal keratoconjunctivitis (VKC; n = 21) and normal subjects (n = 20). None of them had received steroids or other anti–inflammatory agents. Conjunctival expressions of CCR4, CCR5 and HLA–DR were obtained and quantified using flow cytometry.
CCR4 was overexpressed in the uveitis group (mean: 22% of positive cells) and in the VKC group (mean: 44 %) and was significantly higher than in samples from normal subjects (mean of 3.5 %). 13 of 16 patients in the uveitis group were considered as CCR4–positive (values higher than twice the mean value of CCR4 in the normal group). CCR5 was expressed by only few cells in all groups (means of 3.7 % in uveitis, 1.9 % in VKC and 2.4 % in normal subjects). Only 3 of 16 patients in the uveitis group were considered as CCR5–positive. HLA–DR expression by conjunctival cells was significantly increased in uveitis (mean of 63%) as compared to normal subjects (mean of 22 %) and in VKC (mean of 23 %).
This study shows that immunoinflammatory markers could be found on ocular surface of patients with uveitis. CCR4, classically related to the TH2 system, and HLA–DR are both overexpressed by conjunctival cells of patients with uveitis while CCR5, related to the TH1 system, was barely expressed. Inflammatory mechanisms at the level of the ocular surface in uveitis may reflect those of the intraocular inflammation and their exploration in uveitis could represent a new way to better understand the immune pathways involved in this complex disease.
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