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Arnaud Sauer, Gilles Prevost, Christophe Chiquet, Catherine P. Garcher, Jean-Paul Berrod, Alain M. Bron, Odile Villard, Claude Speeg-Schatz, Ermanno Candolfi, Tristan Bourcier; Regulation Of Immune Response In Post-operative Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5623.
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Endophthalmitis is the most feared complication of all ophthalmologic surgeries. Taking into account the opposing needs of limiting pathogen multiplication and minimizing tissue destruction, both antibiotics and anti-inflammatory drugs are needed for endophthalmitis care. The aim of our study is to study the immune response in aqueous humor of infected patients.
In a prospective and multicenter study, aqueous humors of patients with endophthalmitis and control (cataract surgery) were collected. Multiplex immunoassay (Bioplex*) was done in order to define cytokines patterns. Twenty-seven cytokines, chemokines and growth factors were studied. Two-way ANOVA test was realized for each inflammatory marker to determine any difference between infected and control patients.
Aqueous humor was sampled in 24 patients with endophthalmitis and 88 controls. Endophthalmitis was leading to high levels of cytokines and chemokines of the Th1 (Interleukin (IL)-2, IL-15, IFN-γ, TNF-α, IL-7, G-CSF, MCP-1, IL-8, IP-10) and Th17 (IL-17, IL-6, IL-1b) ways (p < 0,0001). To the contrary, Treg markers (IL-10, IL-27) were not increased. Moreover, very high levels of VEGF and FGF were noted in aqueous humors of patients with endophthalmitis as compared to the control (p < 0,0001).
Th1 and Th17 cells may play an important anti-infectious role in modulating pathogen proliferation in infected eyes, and repressing Treg cells. But this huge inflammatory response may be responsible for retinal destruction as a collateral effect. Moreover, pro-angiogenic factors are secreted in infected eyes. Antagonism of TH17 by Tregs cells and anti-angiogenic drugs could be a way to limit ocular lesion and may open new therapeutic approach by stimulating Tregs cells or repressing TH17 cells.
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