Abstract
Primary intraocular lymphoma (PIOL), also called primary vitreoretinal lymphomas, often masquerades as uveitis. This misdiagnosis can result in subsequent brain involvement and oculocerebral lymphoma (OCL). In this study, we sought to characterize the helper T-cell type 1 (Th1)/Th2 cytokine profile in vitreous samples from patients with PIOL, OCL, uveitis and controls with non-inflammatory disease. Vitreous and aqueous humor samples from 87 patients with PIOL (n = 30), OCL (n = 12), uveitis (n = 34), and retinal detachment (RD) without hemorrhage (n = 11) were analyzed and their concentrations of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were determined by flow cytometric bead arrays (CBA). The IL-10 levels determined by CBA were compared with those by ELISA. IL-10 concentrations measured by CBA and ELISA were highly correlated. IL-2, IL-4, and TNFα were not detected in any sample. The only cytokine detected at a significant level in samples from RD vitreous was IL-6. The IL-10/IL-6 ratio, as previously reported, was slightly higher in PIOL than in uveitis samples, but not for all patients. Cytokine profiles from PIOL and OCL samples did not differ. The combination of the IL-10/IL-6 and IL-10/IFNγ ratios was highly informative for discriminating PIOL/OCL from uveitis samples and for therapeutic follow up of PIOL. This strategy might be very helpful as an initial screening to rule out PIOL in patients thought to have uveitis.
Highlights
Primary intraocular lymphoma (PIOL), called primary vitreoretinal lymphomas [1], is a subset of primary central nervous system lymphoma (PCNSL) that initially presents in the eye, with or without simultaneous CNS involvement [2,3]
IL-10 concentrations measured by cytometric bead array (CBA) and correlation with ELISA
Before using the CBA multiplex technology to analyze the Th1/Th2 cytokine profiles of PIOL, oculocerebral lymphoma (OCL), and uveitis patients, we compared the IL-10 results produced by ELISA and CBA
Summary
Primary intraocular lymphoma (PIOL), called primary vitreoretinal lymphomas [1], is a subset of primary central nervous system lymphoma (PCNSL) that initially presents in the eye, with or without simultaneous CNS involvement [2,3]. The exact cutoff for the IL-10 concentration or IL-10/IL-6 ratio may vary between laboratories, mainly due to differences in methods and conditions of sample harvesting and storage, techniques, and manufacturers of equipment and supplies, as well as the dilution (known or unknown) of the vitreous samples and the laboratory’s own experience. These factors result in false-positive (11%) and false-negative (23 to 30%) PIOL diagnoses [6,8,9,10]. Cytokine ratios from the different groups of samples were compared and allowed us to define a new strategy for discriminating patients with PIOL or OCL from those with uveitis
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