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Abstract #6797 Published in IGR 4-1
Profile of cytokines in aqueous humor from corneal graft recipients
Dekaris I; Gabric N; Mazuran R; Karaman Z; Mravicic ICroatian Medical Journal 2001; 42: 650-656
AIM: Due to the immune privilege of the anterior eye chamber, the success rate of corneal transplantation can reach 90%. The aim of this study was to determine cytokine profile in aqueous humor of patients undergoing corneal transplantation, and to establish whether cytokine profile at the time of surgery influenced corneal graft outcome. METHODS: Proinflammatory (TNFβ and IFNγ) and immunosuppressive (TGFβ2) cytokine levels were measured in aqueous humor and serum of 44 patients. Non-inflammatory corneal diseases included keratoconus (n = 8), bullous keratopathy (n = 7), and stromal dystrophy (n = 3). Inflammatory diseases included corneal scars (n = 10), graft rejection (n = 5), pending perforation (n = 4), chemical burns (n = 4), rejection/uveitis (n = 1), infectious keratitis (n = 1), and perforated ulcer (n = 1). Control aqueous humor and sera were obtained from cadavers without corneal pathology. RESULTS: The concentration of TGFβ2 in the aqueous humor in non-inflammatory corneal diseases was similar to that of controls (2605 ± 204 pg/ml versus 2200 ± 100 pg/ml). In inflammatory corneal diseases, the concentration of TGFβ2 in the aqueous humor was significantly lower (1400 ± 375 pg/ml, p < 0.001). TNFβ was detected in the aqueous humor of 16 of 26 patients with inflammatory corneal diseases and in all patients with stromal dystrophies, but was undetectable in cases of keratoconus and bullous keratopathy. Low levels of IFNγ were present in all aqueous humor samples. Patients' sera contained significantly less cytokine (up to 252 pg/ml) then their aqueous humor (p < 0.001). We have set an arbitrary cut-off point for TGFβ2 level in aqueous humor at 1500 pg/ml and divided all investigated samples (from 44 patients and ten controls) into two groups, one with high and the other with low TGFβ2 concentration. The coefficient of contingency showed that patients with high TGFβ2 concentration in their aqueous humor had significantly greater chance for graft acceptance than those with low TGFβ2 concentration (p < 0.001). CONCLUSIONS: High TGFβ2 concentrations in eyes without intraocular inflammation suggest its immunosuppressive role in human eyes. A high concentration of TGFβ2 (> 1500 pg/ml) was associated with graft acceptance. Also, absence of proinflamatory TNFβ increased the graft acceptance, but independently from TGFβ2.
Dr. I. Dekaris, Lions Croatian Eye Bank, Department of Ophthalmology, Holy Ghost General Hospital, Zagreb, Croatia. iva.dekaris@eeba.net
Classification:
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
