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Cytokine analysis of aqueous humor in HIV patients with cytomegalovirus retinitis

机译：HIV巨细胞病毒性视网膜炎患者房水的细胞因子分析

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Purpose: 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 100. μl 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. Conclusion: 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.
机译：目的：巨细胞病毒性视网膜炎（CMVR）是艾滋病患者中最常见的机会性眼部感染。 CMVR患者尚未对房水的免疫学因素进行全面分析。这项研究旨在对CMVR患者的房水进行全面的免疫因子分析，以确定房水中是否存在任何特征性免疫学特征。方法：对三组房水进行了比较前瞻性分析：（1）患有CMVR的AIDS患者（CMVR组）（n =。20），（2）没有CMVR的HIV阳性患者（HIV组）（n =。6） ）和（3）接受白内障手术且无潜在的眼部感染或炎症的患者（对照组）（n = 11）。从所有受试者中抽取至少100μl房水，并在使用Milliplex Human Cytokine？通过FlexMAP 3D（Luminex？）平台分析41种细胞因子，趋化因子和生长因子之前进行分级分离。套件。结果：在三组房水中观察到三个不同的免疫学特征。在三组中观察到统计学上的显着差异（p <.0.05），其中HIV组的水平较低，而CMVR组的水平升高是由于以下因素：IP-10，fractalkine，PDGF-AA，G-CSF，Flt-3L和MCP-1。结论：尽管CMVR在临床上处于静止状态，但房水显示出独特的免疫学特征，与Th-1和单核细胞巨噬细胞介导的反应相结合。随后通过治疗过程对CMVR的细胞因子水平进行纵向分析，可以更好地了解CMVR的免疫病理机制。这也可用于更好地预测疾病，预测并发症并在将来更好地评估治疗反应和个体化治疗。

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