Clinical value of cytokine-hormonal interactions in ophthalmoherpes

    Abstract

    Clinical value of cytokine-hormonal interactions in ophthalmoherpes

    G.H. Zaynutdinova

    Ufa Eye Research Institute

    Purpose. The study of the immune and hormonal changes relationship between herpetic etiology keratitis (НK) and uveitis (UАН) for early prediction of the disease nature and an individualized approach to pathogenetically oriented therapy.

    Material and methods. A correlation analysis of immune parameters (cytokines, lymphocyte subpopulations) and hormonal systems was conducted in 399 patients with НК (254) and UАН (145) treated at in Ufa Eye Research Institute. To establish the etiological diagnosis, the levels of Ig M, G to the herpes simplex virus (HSV) type 1, 2 were determined during the titration of paired patients' blood sera. In all patients, the main cytokines blood levels, VEGF, autoAT to IFN-α, lymphocyte and hormone subpopulations were examined.

    Results. Hormonal and immunological parameters analysis in patients with НK and UАН established their interrelated changes, correlating both among themselves and with the clinical course nature. Inflammation proceeded favorably with an increase in serum cortisol content in the acute stage of HК, along with the number of cytotoxic lymphocytes (r=0.53; p=0.02), immunoregulatory index (r=0.52; p=0.02); HК – with an increase in the level of IL-6 (r=0.81, p=0.02), a decrease – TNF – α (r=-0.9; p=0.02), in male patients with a simultaneous increase in the content testosterone and IL-6 (r=0.74; p=0.02), a decrease in the content of CD95 + lymphocytes (r=-0.68; p=0.02).

    In patients with UАН, the correlation between the content of IL-1RA and antibodies to thyreglobulin (r=0.8463; p=0.035) or antibodies to thyroid peroxidase (r=0.9261; p=0.01) may be a manifestation of autoimmune reactions. The imbalance in the production main thyroid hormones is indicated by interrelated changes in the free thyroxine (T4) levels or total triiodothyronine (T3) and IL-1b (respectively, r=0.9989; p=0.006 and r=0.9602; p=0.043).

    Conclusion. НK and UАН proceed against the background of functional endocrinopathies, which can be based on hormone-regulating cytokine modulations aimed at maintaining homeostasis during inflammatory reactions in the eye, which determines the severity and duration of the clinical course of herpes infection, allows to plan treatment and predict outcomes.

    Key words: herpetic keratitis and uveitis, correlations, cytokines, hormones, lymphocyte subpopulations.