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Jayant Venkatramani Iyer, John Connolly, Rupesh Vijay Agrawal, Tun Kuan Yeo, Bijin Au, Lee Bernett, Stephen C B Teoh; Immune Factor Levels and CMV DNA load in Aqueous Humor of CMV Retinitis - The CRIGSS Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6262.
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© ARVO (1962-2015); The Authors (2016-present)
Analyze the levels of immune factors in the aqueous humor of AIDS patients with cytomegalovirus retinitis (CMVR) in relation to the aqueous viral load and systemic CD4 counts
40 aqueous humor samples were drawn from 8 HIV-positive patients with CMVR through the course of their treatment with weekly intravitreal ganciclovir therapy, as part of the prospective CMV Retinitis Intravitreal Ganciclovir Singapore Study (CRIGSS) over the course of 1 year. The aqueous humor samples were analyzed for CMV DNA viral load and 41 cytokine and chemokine factors using realtime PCR with the FlexMAP 3D (Luminex®) platform and assessed using the Milliplex Human Cytokine® kit. Serum CD4 concentration levels were also obtained through the course of treatment.
The following immune factors (Spearman correlation coefficient r value in parenthesis, p <0.05) showed good positive correlation with CMV DNA load in the aqueous - MCP-1 (0.80, IFN-g (0.83), IP-10 (0.82), IL-8 (0.81), fractalkine (0.73), RANTES (0.68) - while the following showed a moderate positive correlation - PDGF-AA (0.58), Flt-3L (0.59) and G-CSF (0.53). Only PDGF-AA revealed a statistically significant negative correlation with CD4 levels (r=-0.74).
Immune factors indicative of a Th1 and monocyte-macrophage mediated response have shown good correlation with intraocular CMV DNA load, suggestive of a robust localized antiviral response in AIDS patients with CMV. Local CMV DNA load rather than systemic CD4 levels may correlate better with underlying clinical response to CMV in the eye and may thus be an important factor to consider in optimization and individualization of treatment regime for patients with CMVR.
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