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P. Maier, U. Heizmann, D. Boehringer, Y. Kern, T. Reinhard; Multiplex Analysis of Cytokines in the Aqueous Humor Before and Following Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1961.
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Cytokine patterns in the aqueous humor before penetrating keratoplasty might allow the prediction of the development and the course of endothelial immune reactions. Therefore, we analysed six different cytokines in the aqueous humor of patients with various ophthalmic diseases.
Patients in group I (control group, n=72) suffered only from cataract. Group II (n=29) comprised patients with cataract and glaucoma. Group III (n=101) included patients receiving penetrating keratoplasty. Group IV (n=12) consisted of patients with cataract after penetrating keratoplasty without endothelial immune reaction and patients in group V received irrigation of the anterior chamber due to endothelial immune reactions. In all samples we measured Interleukin-1b, Interleukin-6, Interleukin-8, Interleukin-10, Interleukiin-12 und TNF-alpha with a zytometric bead array.
Interleukin-6 was increased in group V (median 736.4pg/ml) compared to all other patients (median group I: 26.0 g/ml, group II: 24.2pg/ml, group III: 13.9pg/ml, group IV: 49.8pg/ml). Interleukin-10 was higher in group IV (median 3.45 pg/ml) and V (median 2.6pg/ml) compared to groups I (median 1.95pg/ml), II (median 0 pg/ml) and III (median 2.1pg/ml). In group V (median 2.6pg/ml) TNF-alpha was statistically significantly higher than in group III (median 0pg/ml).
Increased levels of Interleukin-6 and TNF-alpha in the aqueous humor of patients with endothelial immune reactions show their important role as mediators for immune reactions following penetrating keratoplasty. Antagonising such cytokins might be a option for the treatment of immune reactions in the future. High levels of Interleukin-10 may cause a downregulation of the Th1 mediated delayed type hypersensitivity. This could represent a donor-specific activation of the immune privilege of the anterior chamber as the levels of Interleukin-10 were highest after penetrating keratoplasty without endothelial immune reaction. Whether the analysis of cytokine patterns in the aqueous humor before penetrating keratoplasty allows a prediction of the development of immune reactions, will be investigated in further prospective, clinical studies.
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