Regulation of immune response in post‐operative endophthalmitis

Abstract

AbstractPurpose Endophthalmitis is the most feared complication of all ophthalmologic surgeries. The aim of our study is to study the immune response in aqueous humor of infected patients.Methods In a prospective and multicenter study, clinical datas and aqueous humors of patients with endophthalmitis and control (cataract surgery) were collected. Multiplex immunoassay was done in order to define cytokines patterns. Two‐way ANOVA test was realized for each inflammatory marker to determine any difference between infected and control patients. Pearson linear regression was done to analyse correlation between clinical datas and cytokines levels.Results Aqueous humor was sampled in 49 patients with endophthalmitis and 88 controls. Microbial identification was obtained in 67% of cases. Endophthalmitis was leading to high levels of cytokines and chemokines of the Th1, Th17 and Treg ways. Moreover, very high levels of VEGF were noted in aqueous humors of patients with endophthalmitis as compared to the control. Better visual acuity after one year of evolution was correlated with decreased levels of IL‐8, MCP‐1 and VEGF.Conclusion Th1 and Th17 cells may play an important anti‐infectious role in modulating pathogen proliferation in infected eyes. But this huge inflammatory response may be responsible for retinal destruction as a collateral effect. Moreover, pro‐angiogenic factors are secreted in infected eyes. Antagonism of TH17 and anti‐angiogenic drugs could be a way to limit ocular lesion and may open new therapeutic approach associated with antibiotics therapy.