Dominance of activated T cells and interleukin-6 in aqueous humor in Vogt-Koyanagi-Harada disease.
OBJECTIVE
To determine the immunopathologic role of the lymphocytes and lymphokines in aqueous humor (AH) of patients with Vogt-Koyanagi-Harada disease (VKH).


METHODS
The distribution of leukocyte subsets in the peripheral blood and AH was examined using fluorescein isothiocyanate-conjugated monoclonal antibodies. The levels of lymphokines, such as interleukin-2 (IL-2) and interleukin-6 (IL-6), in the sera, AH, and cerebrospinal fluid from the patients with VKH were determined using an enzyme-linked immunosorbent assay.


RESULTS
T cells constituted the majority of lymphocytes within AH. The value for CD4+ cells (helper/inducer T lymphocytes) in AH was 51.7% +/- 14.9% (mean +/- SD) and that for CD8+ cells (cytotoxic/suppressor T lymphocytes) was 31.1% +/- 13.0%. The percentage of HLA-DR+ cells (B lymphocytes, monocytes, macrophages, and activated T lymphocytes) in AH (50.8% +/- 24.9%) significantly exceeded (P < 0.001) that in blood (13.1% +/- 4.2%). The percentage of CD8+ cells in AH from three patients with the delayed type of VKH rose during their clinical course. The level of IL-6 was significantly elevated in AH from the patients with VKH. The level of IL-6 in AH correlated with the number of lymphocytes in AH, and it reflected the severity of the inflammatory response in AH of patients with VKH. The level of IL-2 in the sera, AH, and cerebrospinal fluid was in the normal range.


CONCLUSIONS
Aqueous humor lymphocytes from the patients with VKH were more activated than were peripheral blood lymphocytes. IL-6 may play an important role as an inflammatory mediator in VKH. It may be useful to analyze the lymphocyte subsets and the levels of lymphokines, especially of IL-6, at the site of inflammation in uvea to improve the criteria for assessing the prognosis of VKH.
Norose
K
K
Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Japan.
Yano
A
A
Wang
X C
XC
Tokushima
T
T
Umihira
J
J
Seki
A
A
Nohara
M
M
Segawa
K
K
D000328:Adult; D000911:Antibodies, Monoclonal; D001082:Aqueous Humor / Q000166:cytology / Q000276:immunology*; D002555:Cerebrospinal Fluid / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis*; D007962:Leukocytes / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology*; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D014607:Uveomeningoencephalitic Syndrome / Q000276:immunology*
D000911:Antibodies, Monoclonal; D007376:Interleukin-2; D015850:Interleukin-6