Abstract
Purpose To compare the intraocular cytokine and chemokine profiles in patients with acute primary acquired ocular toxoplasmosis (pOT) or recurrent ocular toxoplasmosis (rOT) and to correlate them with their clinical characteristics. Methods Aqueous humor samples were collected from 62 consecutive patients (21 pOT, 30 rOT, and 11 noninfected controls) and analyzed by multiplex assay. Correlations were assessed between cytokine/chemokine levels, type of inflammatory response (Th1, Th2, and Th17), and clinical characteristics. In all OT patients, the clinical diagnosis of either pOT or rOT was confirmed by positive intraocular Goldmann/Witmer-Desmonts coefficient. Correlations were assessed between a preselected panel of immune mediators and the clinical characteristics of OT. Results In pOT patients, increased levels of IL-2, IFN-γ, TNF-α, IL-15, IL-4, IL-5, IL-9, IL-13, IL-17, IL-1Rα, IL-6, IL-1β, and chemokines MIP-1α, MIP-1β, IP-10, Eotaxin, IL-8, RANTES, PDGF-bb, GM-CSF, G-CSF, and MCP-1 were found in comparison to those in controls (p < 0.05). Patients with rOT showed elevated levels of IL-2, IFN-γ, TNF-α, IL-15, IL-4, IL-5, IL-9, IL-17, IL-1Rα, IL-6, IL-1β, and chemokines MIP-1α, IP-10, Eotaxin, IL-8, RANTES, PDGF-bb, G-CSF, and MCP-1 compared to controls (p < 0.05). In addition, IL-7 (p = 0.028) differed between pOT and rOT; IL-9 (p = 0.054) and IL-13 (p = 0.051) showed a tendency of higher concentration in pOT than in rOT. A negative correlation was found between IL-7 (p = 0.017) as well as IL-9 (p = 0.008) and the number of recurrences. Cytokine ratios showed no difference between pOT and rOT, indicating a dominant Th1-type response in both infectious groups. Moreover, a positive correlation was detected between IL-7, VEGF, IL-13 and age at aqueous humor sampling (p < 0.05). Conclusions This study for the first time shows subtle differences between the intraocular cytokine profiles in patients with either acute pOT or rOT.
Highlights
The protozoan Toxoplasma gondii (T. gondii) establishes a lifelong chronic infection that targets neuronal tissues such as the brain and the retina
Based on the predefined diagnostic criteria, 21 patients presented with primary acquired ocular toxoplasmosis (pOT), whereas 30 individuals suffered from recurrent ocular toxoplasmosis (rOT) [9]
Increased levels of IFN-γ, TNF-α, IL-4, IL-17, IL-6, MIP-1α, MIP-1β, IP-10, IL-8, RANTES, and MCP-1 were detected in both primary and recurrent Ocular toxoplasmosis (OT) compared to controls
Summary
The protozoan Toxoplasma gondii (T. gondii) establishes a lifelong chronic infection that targets neuronal tissues such as the brain and the retina. Ocular toxoplasmosis (OT) remains one of the leading causes of visual impairment and is the most frequent cause of infectious posterior uveitis [1] It typically presents with focal inflammation and necrosis of the neurosensory retina, affecting retinal glial and pigment epithelial cells [2]. The genotype of the pathogen has been recognized for some time, as more virulent strains with pronounced clinical manifestations are observed, in particular in South America compared to Europe [1, 3]. This impacts the immune response and clinical course of T. gondii infections. During the acute stage of the infection, an intraocular IFN-γ-mediated immune response
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