Abstract
Purpose:
To demonstrate the correlation between emotional stress, pro-inflammatory and anti-inflammatory cytokines in the activity of anterior uveitis.
Methods:
An analytical, transversal, observational and prospective study was done including patients with autoimmune anterior uveitis. Patients were divided in two groups: active anterior uveitis (AAU) o inactive anterior uveitis (IAU) according to the SUN criteria. Five psychiatric stress tests (PST): Q-LES-Q, GHQ28, STAI, SASS and Sheehan were applied in all cases. Tear samples were obtained at the same time to measure pro-inflammatory cytokines IL-1beta, IL-6, IL-8, TNF-alpha, and the anti-inflammatory cytokines: IL-10 and IL-12p70 and these cytokines levels were determined by cytometric bead arrays. Data were analyzed with U Mann-Withney tests and Spearman correlation test.
Results:
Fifteen AAU patients and 7 IAU patients were included. We found an increased statistical difference (p<0.05) in the levels of pro-inflammatory cytokines between AAU (IL-1beta: 17.01+/-20.49pg/ml, IL-6: 29.92+/-64.79pg/ml, IL-8: 240.9 +/- 178.9pg/ml), and IAU (IL-1beta: 3.87+/-8.71pg/ml, IL-6: 2.75+/-5.49pg/ml, IL-8: 121.9+/-38.25pg/ml). There was not statistical difference in levels of TNF-alpha, IL-10 and IL-12p70 between the two groups. In psychiatric tests there was a statistical difference (p<0.05) in all parameters related with stress between AAU and IAU. The correlation between levels of cytokines and the clinical score obtained from PST showed a statistical difference (p<0.05).
Conclusions:
Increased levels of emotional stress in the AAU patients are correlated with increased levels of pro-inflammatory cytokines. There was no difference between anti-inflammatory cytokines. This study demonstrates the importance of the multidisciplinary approach in patients with AAU at least by ophthalmology and psychiatry specialist.
Keywords: 490 cytokines/chemokines •
746 uveitis-clinical/animal model •
726 stress response