Are cytokine patterns in aqueous humour useful in distinguishing corneal graft rejection from opacification due to herpetic stromal keratitis?
OBJECTIVE
Intra-ocular cytokine profiles were determined to study the immunological mechanisms of corneal graft opacification due to rejection and/or herpetic stromal keratitis (HSK).


METHODS
Sera and aqueous humour (AH) were sampled shortly after the onset of corneal graft opacification, group I (n=18). In eyes with clear grafts, samples were taken 5 months after transplantation, group II (n=59). Samples of non-inflamed eyes, prior to cataract surgery, were used to determine baseline cytokine levels, group III (n=49). Total protein (TP) levels were measured with Bradford reagent and interleukin (IL)-6, IL-10, IL-4 and interferon (IFN)-gamma with ELISAs.


RESULTS
All patients who's corneal grafts showed clinical evidence of graft opacification due to rejection and/or HSK were sampled. In the AH-samples of group I, increased levels of TP were found in 60% (9/15), IL-6 in 79% (11/14), IL-10 in 39% (7/18) and IL-4 in none (0/12). IFN-gamma was detected in 19% (3/16), in the case of HSK only. In contrast, samples obtained from patients with clear grafts in group II showed increased levels of TP in 36% (20/55), IL-6 in 14% (8/57) and IL-10, IL-4 or IFN-gamma in none (n=58).


CONCLUSIONS
During corneal graft rejection and/or HSV-infection, increased levels of TP and IL-6 in AH confirmed anterior chamber inflammation with breakdown of the blood-aqueous barrier. Based on the data presented, cytokine patterns in the AH do not appear to distinguish corneal opacification due to graft rejection from that due to herpes keratitis.
van Gelderen
E B
EB
Department Ophthalmo-lmmunology, The Netherlands Ophthalmic Research Institute, Amsterdam.
Van der Lelij
A
A
Völker-Dieben
H J
HJ
van der Gaag
R
R
Peek
R
R
Treffers
W F
WF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001082:Aqueous Humor / Q000378:metabolism*; D003318:Corneal Opacity / Q000209:etiology / Q000378:metabolism*; D003319:Corneal Stroma / Q000821:virology*; D016207:Cytokines / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005136:Eye Proteins / Q000378:metabolism; D005260:Female; D006084:Graft Rejection / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
D016207:Cytokines; D005136:Eye Proteins