title: Cytokine analysis of aqueous humor in HIV patients with cytomegalovirus retinitis.
abstract: OBJECTIVE
  Cytomegalovirus retinitis (CMVR) is the most common opportunistic ocular infection in patients with AIDS. Comprehensive analysis of aqueous humor for immunologic factors has yet to be performed in patients with CMVR. This study aims to perform comprehensive immune factor analysis of aqueous humor in CMVR patients to determine the presence of any characteristic immunological profile in the aqueous humor.
  
  
  METHODS
  Comparative prospective analysis of aqueous humor was performed across three groups: (1) AIDS patients with CMVR (CMVR group) (n=20), (2) HIV-positive patients without CMVR (HIV group) (n=6) and (3) patients undergoing cataract surgery with no underlying ocular infection or inflammation (control group) (n=11). At least 100μl of aqueous humor was drawn from all subjects and fractionated prior to analysis for 41 cytokines, chemokines and growth factors with the FlexMAP 3D (Luminex®) platform using the Milliplex Human Cytokine® kit.
  
  
  RESULTS
  Three distinct immunologic signatures were observed in the aqueous humor of the three groups. Statistically significant differences (p<0.05) were observed across the three groups with the HIV group having lower levels and CMVR group having raised levels for the following factors: IP-10, fractalkine, PDGF-AA, G-CSF, Flt-3L and MCP-1.
  
  
  CONCLUSIONS
  Aqueous humor though clinically quiescent in CMVR revealed a unique immunologic signature consistent with a combined Th-1 and monocyte-macrophage mediated response. Subsequent longitudinal analysis of aqueous cytokine levels of CMVR through the course of treatment would allow better understanding of the immunopathogenetic mechanisms of CMVR. This may also be used to better prognosticate the disease, predict complications and allow better assessment of treatment response and individualization of treatment in the future.
authors.affiliation: National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Singapore National Eye Center, Singapore.
authors.forename: Jayant Venkatramani
authors.initials: JV
authors.lastname: Iyer
authors.forename: John
authors.initials: J
authors.lastname: Connolly
authors.forename: Rupesh
authors.initials: R
authors.lastname: Agrawal
authors.forename: Tun Kuan
authors.initials: TK
authors.lastname: Yeo
authors.forename: Bernett
authors.initials: B
authors.lastname: Lee
authors.forename: Bijin
authors.initials: B
authors.lastname: Au
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Teoh
mesh_terms: D000704:Analysis of Variance; D001082:Aqueous Humor / Q000378:metabolism* / Q000821:virology*; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism*; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000276:immunology / Q000378:metabolism*; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D016207:Cytokines
keywords: Aqueous humor; Chemokine; Cytokine; Cytomegalovirus retinitis; HIV