Abstract
Abstract: :
Purpose: To investigate the differences of the pathogenesis of chronic recurrent uveitis with or without systemic disease, the infiltrating inflammatory cells were analyzed from the anterior chamber of patients with chronic uveitis. Methods: Aqueous humor and peripheral blood samples were obtained with consent from patients with chronic recurrent uveitis at the time of active intraocular inflammation. Phenotypes of the leukocytes (CD3, CD4, CD8, CD14, CD19 and CD94) in aqueous humor and peripheral blood were analyzed by flow cytometry. The causes of uveitis were divided into isolated uveitis and systemic disease-associated uveitis. The phenotypic characteristics were compared between these two groups and according to the specific diagnosis. Results: Total of 34 patients was recruited. The causes of isolated uveitis (20 patients) were idiopathic recurrent anterior uveitis, pars planitis and HLA-B27-associated uveitis. The causes of systemic disease-associated uveitis (14 patients) were Behcet disease, Vogt-Koyanagi-Harada disease, sarcoidosis and ankylosing spondylitis. CD4+ T cells were predominant in the aqueous from the patients with chronic uveitis except from those with Behcet disease in which CD8+ T cells were predominant. B cells (CD19+) were rarely seen in the aqueous humor from all the patients with chronic uveitis. Monocytes (CD14+) were rare in isolated chronic uveitis but common in chronic uveitis associated with systemic disease. Aqueous from all six patients with Behcet disease showed increase in CD3+ CD94+ NKT cells when compared with those from other uveitis. These differences were not reflected in the peripheral blood where there was no difference in cell proportions. Conclusion: The immunopathogenesis of chronic uveitis is thought to be somewhat different depending on the associated systemic disease. Behcet disease had a unique intraocular inflammatory cell population among the various types of chronic uveitis probably due to a different pathogenetic mechanism. The analysis of the chamber cells from the patients with chronic uveitis may thus be important in characterizing the pathogenesis and the differential diagnosis of various types of chronic uveitis.
Keywords: 612 uveitis-clinical/animal model • 413 flow cytometry • 324 aqueous