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Takeshi Kezuka, Yoshihiko Usui, Mieko Hirano, Yoko Okunuki, Naoyuki Yamakawa, Hiroshi Goto; Peripheral Blood Mononuclear Cell Cytokine Production And Response To Steroid Therapy In Patients With Optic Neuritis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4315.
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© ARVO (1962-2015); The Authors (2016-present)
To elucidate the sensitivity to corticosteroids in patients with optic neuritis, we measured the cytokines derived from peripheral blood mononuclear cells (PBMCs) and investigated the correlation with the clinical course.
Ten patients with active optic neuritis (3 males and 7 females, aged 27-65 years, mean 42 years) followed for a mean period of 6.2 months were studied. Before steroid therapy, PBMCs were isolated and cultured for 24 h with concanavalin A and different concentrations of betamethasone. The IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10 and IL-17 concentrations in the supernatant were measured using the Cytometric Bead Array Flex kit and ELISA. The amounts of cytokine production were compared with the clinical course.
Visual acuity was from hand motion to 20/250 at presentation, and improved after steroid therapy to 20/25 in 9 of 10 patients. The percent reduction in cytokine production by adding betamethasone significantly correlated with the degree of visual improvement. The mean total steroid dose converted to prednisolone was 4,460 ± 2,480 mg. There was no significant relation between individual total doses and reduction in cytokine production by adding betamethasone to PBMC cultures. In 1 patient in whom IL-17 production did not decrease by the addition of betamethasone to PBMC culture, visual acuity did not improve despite a total steroid dose of over 6,000 mg, and improvement was obtained only after plasmapheresis.
Although the number of cases was limited, the present results suggest that in vitro steroid sensitivity test using PBMC may be a useful indicator for predicting visual outcome after steroid therapy and deciding the optimal treatment method in patients with optic neuritis.
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