title: Are cytokine patterns in aqueous humour useful in distinguishing corneal graft rejection from opacification due to herpetic stromal keratitis?
abstract: 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.
authors.affiliation: Department Ophthalmo-lmmunology, The Netherlands Ophthalmic Research Institute, Amsterdam.
authors.forename: E B
authors.initials: EB
authors.lastname: van Gelderen
authors.forename: A
authors.initials: A
authors.lastname: Van der Lelij
authors.forename: H J
authors.initials: HJ
authors.lastname: Völker-Dieben
authors.forename: R
authors.initials: R
authors.lastname: van der Gaag
authors.forename: R
authors.initials: R
authors.lastname: Peek
authors.forename: W F
authors.initials: WF
authors.lastname: Treffers
mesh_terms: 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
chemical_list: D016207:Cytokines; D005136:Eye Proteins