April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Peripheral Blood Mononuclear Cell Cytokine Production And Response To Steroid Therapy In Patients With Optic Neuritis
Author Affiliations & Notes
  • Takeshi Kezuka
    Ophthalmology, Tokyo Medical Univ Hospital, Tokyo, Japan
  • Yoshihiko Usui
    Ophthalmology, Tokyo Medical Univ Hospital, Tokyo, Japan
  • Mieko Hirano
    Ophthalmology, Tokyo Medical Univ Hospital, Tokyo, Japan
  • Yoko Okunuki
    Ophthalmology, Tokyo Medical Univ Hospital, Tokyo, Japan
  • Naoyuki Yamakawa
    Ophthalmology, Tokyo Medical Univ Hospital, Tokyo, Japan
  • Hiroshi Goto
    Ophthalmology, Tokyo Medical Univ Hospital, Tokyo, Japan
  • Footnotes
    Commercial Relationships  Takeshi Kezuka, None; Yoshihiko Usui, None; Mieko Hirano, None; Yoko Okunuki, None; Naoyuki Yamakawa, None; Hiroshi Goto, None
  • Footnotes
    Support  Grant-in-Aid for Scientific Research (C) 22591967 from the Japanese Ministry of Education and by Human Health Science Foundation.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4315. doi:
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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)

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Abstract

Purpose: : 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.

Methods: : 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.

Results: : 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.

Conclusions: : 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.

Keywords: neuro-ophthalmology: optic nerve • immunomodulation/immunoregulation • neuro-ophthalmology: diagnosis 
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