Elevated Levels of Cytokines Associated with Th2 and Th17 Cells in Vitreous Fluid of Proliferative Diabetic Retinopathy Patients.
Macrophages are involved in low-grade inflammation in diabetes, and play pathogenic roles in proliferative diabetic retinopathy (PDR) by producing proinflammatory cytokines. T cells as well as other cells are also activated by proinflammatory cytokines, and infiltration into the vitreous of patients with PDR has been shown. In this study, we measured helper T (Th) cell-related cytokines in the vitreous of PDR patients to define the characteristics of Th-mediated immune responses associated with PDR. The study group consisted of 25 type 2 diabetic patients (25 eyes) with PDR. The control group consisted of 27 patients with epiretinal membrane (ERM), 26 patients with idiopathic macular hole (MH), and 26 patients with uveitis associated with sarcoidosis. Vitreous fluid was obtained at the beginning of vitrectomy, and centrifuging for cellular removals was not performed. Serum was also collected from PDR patients. IL-1β, IL-4, IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, IFN-γ, soluble sCD40L, and TNFα in the vitreous and serum samples were measured. Both percent detectable and levels of IL-4, IL-6, IL-17A, IL-21, IL-22, and TNFα in the vitreous were significantly higher than those in the serum in PDR patients. Vitreous levels of these cytokines and IL-31 were significantly higher in PDR than in ERM or MH patients. Vitreous levels of IL-4, IL-17A, IL-22, IL-31, and TNFα in PDR patients were also significantly higher than those of sarcoidosis patients. In PDR patients, vitreous IL-17A level correlated significantly with vitreous levels of IL-22 and IL-31, and especially with IL-4 and TNFα. Although it is unclear whether these cytokines play facilitative roles or inhibitory roles for the progression of PDR, the present study indicated that Th2- and Th17-related immune responses are involved in the pathogenesis of PDR.
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Masaru
M
Takeuchi
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Tomohito
T
Sato
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Atsushi
A
Tanaka
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Tadashi
T
Muraoka
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Manzo
M
Taguchi
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Yutaka
Y
Sakurai
Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Yoko
Y
Karasawa
Department of Developmental Anatomy and Regenerative Biology, National Defense Medical College, Saitama, Japan.
Masataka
M
Ito
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016207:Cytokines / Q000097:blood / Q000276:immunology / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000097:blood* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D005123:Eye / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D007249:Inflammation / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D008264:Macrophages / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000378:metabolism / Q000473:pathology; D012507:Sarcoidosis / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D058504:Th17 Cells / Q000276:immunology / Q000378:metabolism; D018418:Th2 Cells / Q000378:metabolism / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology / Q000378:metabolism; D014605:Uveitis / Q000378:metabolism / Q000473:pathology; D014821:Vitrectomy; D014822:Vitreous Body / Q000276:immunology / Q000378:metabolism / Q000473:pathology
D016207:Cytokines; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha