Purpose

To determine the cytokine expression profile in the tears of patients with uveitis

Methods

It is cross sectional study of tear analysis of uveitis patients in a tertiary eye care centre from south India using biomarker kit with age matched controls. Schirmer strips were transformed into 1.5 ml microcentrifuge tubes and extraction buffers were added. After mixing, 50 microliter of tears were added to the circular wells in the cartridge and a wash buffer was added in the triangular wells with the microfluidic design. Then it was analysed in a fluorescence reader with Bio M pathfinder for IL-1β, IL-6, IL-10, IL-17A, TNFα, MMP9, VEGF, sICAM1 in tear fluid. Statistical analysis was done using Kruskal Wallis test with Dunn’s multiple comparison test.

Results

Age group range between 6- 90 years with the median age of 44.5 years. 62 patients were male and 74 patients were females. Autoimmune (n=156),Idiopathic (n=50) and Infectious (n=58) , healthy controls (214) results were tabulated, IL-1β IL-6, IL-17A, TNFα MMP9 and sICAM1 are significantly higher in uveitis patients. Coming to anatomical classification of ocular infilammation, IL-1β , IL-17A, TNFα, MMP9, IL6 and sICAM1 were increased in anterior, posterior,and panuveitis entities and IL10 is increased in episcleritis. In specific etiologies, IL-1β, IL-6 & MMP9 are elevated in post fever retinitis and tuberculosis . VEGF levels increased in post fever retinitis cases. In viral uveitis, MM 9 levels are elevated.

Conclusions

IL-1β, IL-6, IL-17A, TNFα, MMP9 and sICAM1 are significantly higher in uveitis patients. Based on the current knowledge, analysis and quantification of the cytokines and specific tear markers may help in better understanding of the pathogenesis of uveitis entities to plan future targeted therapy in uveitis.