Aqueous humour cytokine profiles after Descemet\u2019s membrane endothelial keratoplasty

Takahiko Hayashi,Akira Kobayashi,Hidenori Takahashi,Toshiki Shimizu,Satoru Inoda,Hidetoshi Kawashima,Takefumi Yamaguchi,Satoru Yamagami

doi:10.1038/s41598-021-96566-3

Abstract

The aim of this study was to compare aqueous humour (AqH) cytokine profiles before and after Descemet’s membrane endothelial keratoplasty (DMEK) in eyes with bullous keratopathy (BK) and age-matched normal eyes. A total of 49 participants (mean age 75.0 ± 13.5 years) were divided into three groups: (1) BK patients scheduled for DMEK (BK group); (2) patients after DMEK (DMEK group; average postoperative time 1,018 ± 460 days); and (3) control participants without corneal endothelial disease scheduled for cataract surgery (control group). AqH (0.2 mL) was collected from all participants, and the levels of various AqH cytokines were simultaneously measured using a multiplex bead immunoassay. The DMEK group exhibited significantly lower concentrations of several pro-inflammatory cytokines, such as IL-1β, IL-5, IL-6, IL-10, and IL-8, and granulocyte colony stimulating factor than the BK group. In addition, the levels of IL-1β and IL-5 were significantly lower in the DMEK group than in the control group. The AqH levels of several pro-inflammatory cytokines were significantly reduced after DMEK, indicating that regeneration of the endothelial pump owing to the transplantation of a healthy endothelium might have a positive effect on anterior chamber inflammation.

Highlights

The aim of this study was to compare aqueous humour (AqH) cytokine profiles before and after Descemet’s membrane endothelial keratoplasty (DMEK) in eyes with bullous keratopathy (BK) and age-matched normal eyes
We have recently reported the regression of corneal neovascularisation following DMEK25, indicating that healthy corneal endothelial cells (CEnCs) may play a pivotal role in modulating inflammatory conditions in the cornea
We evaluated the cytokine profiles of IL-2, IFN-γ, intercellular adhesion molecule (ICAM)-1, IL-5, IL-6, IL-8, IL-10, IL-1β, MCP-1, IL-17A, IP-10, granulocyte colony stimulating factor (G-CSF), and vascular endothelial growth factor (VEGF)-A in the AqH of BK patients before and after DMEK and in a control group without corneal disease

Summary

Introduction

The aim of this study was to compare aqueous humour (AqH) cytokine profiles before and after Descemet’s membrane endothelial keratoplasty (DMEK) in eyes with bullous keratopathy (BK) and age-matched normal eyes. The AqH levels of several pro-inflammatory cytokines were significantly reduced after DMEK, indicating that regeneration of the endothelial pump owing to the transplantation of a healthy endothelium might have a positive effect on anterior chamber inflammation. Compared with other keratoplasty techniques, DMEK displays several advantages, such as excellent and quick visual recovery and a very low rate of allograft rejection[11,12,13] Despite these merits, there is a significant post-operative decrease in corneal endothelial cell density (ECD) over the years. We hypothesised that DMEK surgery ameliorates AqH inflammation by providing healthy CEnCs and, thereby, lowering the levels of inflammatory cytokines. To test this hypothesis, we characterised the cytokine profile in the AqH of eyes before and after DMEK. To the best of our knowledge, this is the first study to analyse AqH in eyes that are in a stable state following DMEK

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