Idiopathic Choroidal Neovascularization: Intraocular Inflammatory Cytokines and the Effect of Intravitreal Ranibizumab Treatment.

Houfa Yin,Xiaoyun Fang,Fang Wu,Zhaoan Su,Min Chen,Panpan Ye,Lei Feng,Jian Ma,Zhiqing Chen,Shenchao Guo,Jinfu Yin,Yabo Yang

doi:10.1038/srep31880

Houfa Yin, Xiaoyun Fang + Show 10 more

Open Access

https://doi.org/10.1038/srep31880

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Abstract

Idiopathic choroidal neovascularization (ICNV) is a disorder that primarily affecting patients younger than 50 years and can cause severe loss of vision. Choroidal abnormalities, especially choroidal inflammation, have been thought to be involved in the pathophysiology of ICNV. However, the exact pathogenesis of ICNV remains unclear. The aim of our study was investigate the levels of 27 inflammatory cytokines in the aqueous humor of eyes with ICNV, and to determine the effect of intravitreal injection of ranibizumab (IVR) on cytokine levels. Significantly higher levels of IL-2, IL-10, IL-15, IL-17, basic FGF, and GM-CSF were observed in patients with ICNV compared with controls. However, only IL-17 levels were significantly higher in patients with ICNV compared with controls after adjusting for axial length. Furthermore, there were significant correlations between the levels of IL-10, IL-17, GM-CSF, and VEGF and the lesion area. Significant changes in visual acuity and central retinal thickness were observed after IVR. Besides VEGF, IVR also significantly reduced the levels of IL-2, IL-10, basic FGF, and IL-12, however, the IL-6 levels were significantly increased. Our results suggest that there may be an involvement of IL-17-related inflammatory processes in the etiology of ICNV.

Highlights

Choroidal abnormalities, such as focal choroiditis, compensation of choroidal vessels, choroidal ischemia, myopia, or impaired functional activities of circulating hematopoietic stem cells have been thought to be involved in the pathophysiology of Idiopathic choroidal neovascularization (ICNV); the exact pathogenesis of ICNV is not yet fully understood[3,5,6,7]
Using the multiplex bead immunoassays, we found significantly higher levels of IL-17 in the aqueous humor of ICNV patients
To the best of our knowledge, our study was the first to analyze the distribution of various inflammatory cytokines in the aqueous humor of ICNV patients and to assess their changes after IVR treatment

Summary

Introduction

Choroidal abnormalities, such as focal choroiditis, compensation of choroidal vessels, choroidal ischemia, myopia, or impaired functional activities of circulating hematopoietic stem cells have been thought to be involved in the pathophysiology of ICNV; the exact pathogenesis of ICNV is not yet fully understood[3,5,6,7]. In order to improve ICNV treatment results, the complex molecular mechanisms involved in the pathogenesis of ICNV must be understood more completely. Inflammatory cytokines such as VEGF and immunoglobulin E were found to be significantly elevated in the serum of patients with ICNV, studies of intraocular inflammatory cytokines in patients with ICNV are sparse[11]. Levels; no correlation between cytokine levels in the aqueous humor and plasma or serum has been detected[12,13]. The purpose of this study was to obtain the profiles of inflammatory cytokines in the aqueous humor of patients with ICNV, and to investigate changes in the levels of various cytokines during anti-VEGF therapy. We evaluated correlations between cytokines and clinical presentations

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