Different composition of intraocular immune mediators in Posner-Schlossman-Syndrome and Fuchs’ Uveitis

Abstract

Posner-Schlossman-Syndrome (PSS) is clinically characterized by acute, recurrent, mild, unilateral uveitis anterior accompanied by elevated intraocular pressure (IOP). Fuchs´ Uveitis (FU) is a chronic, low-grade-inflammatory disorder, involving anterior uvea and vitreous. The clinical findings show remarkable similarities as well as differences. In our study, we determine the composition of immune mediators in aqueous humor of patients with PSS and FU and evaluate if immune mediators play a crucial role in specific viral intraocular inflammation and IOP rises. Aqueous humor samples from 81 uveitis patients (= eyes) presenting with either PSS or FU were collected at one time point. Local intraocular antibody synthesis to rubella virus was confirmed in 65 patients, whereas 16 were tested positively for human cytomegalovirus. Thirteen patients with PSS and 10 patients with FU were treated with glaucoma medications. Additionally, 11 cataract patients acted as control group. Immune mediator concentrations were measured by Bio-Plex Pro assay. We observed in both PSS (IFN-γ: 174.9 pg/mL; TNF-α: 25.1 pg/mL) and FU (IFN-γ: 25.4 pg/mL; TNF-α: 27.2 pg/mL) groups a significantly increased level of T-helper 1 immune mediators compared to controls (IFN-γ, TNF-α: 0 pg/mL) [median]. Notably, PSS patients (IL-1RA: 73.4 pg/mL; IL-8: 199.4 pg/mL; IL-10: 33.4 pg/mL; IP-10: 126350 pg/mL) showed a stronger and more active ocular inflammatory response, than FU patients (IL-1RA: 4.3 pg/mL; IL-8: 72.4 pg/mL; IL-10: 1.6 pg/mL; IP-10: 57400 pg/mL). Furthermore, a negative correlation between mediators and IOP was seen in the PSS group, potentially caused by acetazolamide-treatment. Our findings show that immune mediators play a crucial role in specific viral intraocular inflammation and influence IOP levels. Remarkable similarities but also significant differences of immune mediator concentrations are apparent in PSS compared to FU. High concentrations of IL-1RA, IL-8, IL-10, and IP-10 correlate with active inflammation in PSS, while FU may trigger chronic inflammation. Our data also substantiated a very similar composition of cytokines in those patients from the PSS group suffering from ocular hypertension and thus offers a potential explanation model for a negative correlation between mediators and IOP.

Application of aqueous humor polymerase chain reaction for virus in Posner-Schlossman syndrome

“…Some studies also suggested that some PSS patients were with positive autoimmune markers. Therefore, PSS was thought to be related to autoimmunization [17,18].…”

Relationship Between the Levels of Inflammatory Cytokines in the Aqueous Humor and Cataract in Fuchs Uveitis Syndrome-A Case Control Study

“…As indictated in a previous report, Posner-Schlossman Syndrome (PSS) is a common misdiagnosis for FUS, and only on the basis of clinical ndings, the con rmed diagnosis of FUS was often delayed (mean delay is 4.6 years) [13] . Recently, with the help of an analysis of levels of cytokine levels in the aqueous humor, Pohlmann D et al [19] found that PSS patients showed a stronger and more active ocular in ammatory response, than FUS patients, IL-2, IL-4, IL-5, IL-6, IFN-γ and TNF-α were signi cantly higher in FUS and Posner-Schlossman-Syndrome patients compared to controls. Sijssens et al [20] found that high IL-10 levels are associated with active infectious uveitis are considered to be important in early stage of infection.…”

Relationship Between the Levels of Inflammatory Cytokines in the Aqueous Humor and Cataract in Fuchs Uveitis Syndrome-A Case Control Study

“…and play an important role in anti-infective immune response. Pohlmann D et al [31] found that IL-6 was signi cantly higher in FUS and Posner-Schlossman-Syndrome patients compared to controls. In another study, T. gondii patients had twofold higher levels of IL-6 as compared to healthy subjects, which seems to con rm the presence of an in ammatory state [32] .…”