Potential Biomarkers of Wound Healing after Glaucoma Fistulizing Surgery

    Abstract

    Potential Biomarkers of Wound Healing after Glaucoma Fistulizing Surgery

    N.V. Volkova, T.N. Iureva, Yu.V. Kursakova, Yu.V. Malisheva

    S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk Branch
Irkutsk Medical Academy of Postgraduate Education, Irkutsk
Irkutsk State Medical University, Irkutsk

    Purpose. To determine the concentration of proinflammatory and proangiogenic cytokines of aqueous humor in patients with primary open-angle glaucoma (POAG) before and after trabeculectomy.

    Material and methods. A prospective clinical study of levels of interleukin 8 (IL 8), interleukin 6 (IL 6), and isoforms of vascular endothelial growth factor (VEGF A) in the basal tear of patients with POAG before, 3 days and two months after trabeculectomy by enzyme-linked immunosorbent assay (ELISA) was conducted. Kaplan-Meyer analysis was used to assess the hypotensive efficacy of trabeculectomy in groups; ANOVA-test was used to compare cytokine levels (pg/ml). P<0.05 was considered significant. The follow-up period was 5 years.

    Results. Group 1 (n=29) consisted of patients with complete success of trabeculectomy, group 2 (n=54) consisted of patients with qualified hypotensive success, and group 3 (n=18) consisted of healthy volunteers.

    Before the surgery, IL 8 level was 501.7±165.4 in group 1, 933.7±272.7 in group 2, 338.28±140.4 pg/ml in group 3. Three days after the surgery, IL 8 level was 325.1±105.7 in group 1 and 389,4±176,7 in group 2. Two months after the surgery, IL 8 level was 243,8±126,7 in group 1 and 231.8±65.7 in group 2.

    IL 6 level before the surgery was 21.8±8.7 in the group 1, 48.3±13.9 in group 2, and 8.04±4.42 in group 3. Three days after the surgery, IL 6 level was 34.3±19.2 in group 1 and 66.1±18.7 in the group 2. Two months after the surgery, IL 6 level was 13.9±6.05 in group 1 and 23.45±6.14 in group 2.

    VEGF-A isoforms level before the surgery was 851.4±369.4 in group 1, 895.8±205.7 in group 2, and 164.65±120.7 in group 3. Three days after the surgery, VEGF-A isoforms level was 597.7±224.7 in group 1 and 712.5±305.7 in group 2. Two months after the surgery, it was 698.5±212.7 in group 1 and 795.8±270.9 in group 2.

    Higher concentrations of cytokines are associated with clinical manifestations of inadequate regeneration syndrome.

    Conclusion. Aqueous humor outflow formation is accompanied by a cascade of immuno-inflammatory reactions due to the profile of both proinflammatory and proangiogenic cytokines, whose activity is determined by the initially altered body reactivity.

    Keywords: trabeculectomy, scaring, cytokines, regeneration and reparative process, neoangiogenesis, healing, treatment of scaring.