Evaluation of the Systemic-Local Cytokine Profile in Patients with Pseudoexfoliation Syndrome

Purpose: to investigate the levels of inflammatory and anti-inflammatory cytokines in the aqueous humor and blood plasma of the patients with pseudoexfoliation syndrome (PES). Methods: Inflammatory cytokines (IL-6, IL-10) and anty-inflammatory cytokines (IL-4, IL-8) were measured in ocular fluid samples and blood plasma obtained from patients with PES and cataract (120 eyes), PES and glaucoma (41 eyes), cataract group (45 eyes). The age of patients ranged from 48 to 88 years, an average 65.8 ± 7.1. Patients with systemic diseases and others ocular diseases were excluded. Aspiration of the intraocular fluid was performed using an insulin syringe in a volume of 0.1-0.2 ml. Blood sampling was performed immediately before surgery, and then centrifugation was performed at 3000 rpm. Samples of intraocular fluid and blood serum were immediately frozen at -20.0 and stored until the time of the study. The processing of the results of the study was carried out by the methods of variation and correlation statistics Results: The investigated interleukins were detected in all samples of the anterior chamber aqueous. The level of IL -4 was significantly lower in patients with PES (1,20±0,18) and glaucoma with PES 0,88±0,09 in comparison with cataract group 1,20±0,07 pg/ml. No significant difference in the levels of IL-10 in the ocular fluid of patients was revealed. IL-6 level and IL-10 were significantly higher in anterior chamber aqueous of glaucoma and PES patients in comparison with cataract patients (p<0.05). Various deviations from the control group of proinflammatory and anti-inflammatory cytokines were detected in the the systemic state of cytokines profile. The level of anti-inflammatory IL-4 in the blood serum of PES was increased by 51.7% compared to the control group, while there was no change in the IL-10 level in patients with PES and in combination with glaucoma. Analysis of the level of proinflammatory interleukins in the serum revealed a significant increase in IL - 6 in PES by 18.2%, and in PES and glaucoma - by 48.5% compared to the control group, while the IL - 8 level did not change significantly. Conclusion: The determination of cytokine status in patients with PES and in combination with glaucoma revealed a violation of the local immunological balance, which was manifested by an increase in the activity of pro-inflammatory cytokines (IL-6, IL-8) and a decrease in the activity of anti-inflammatory cytokines (IL-4, IL-10), which reflects deregulatory changes in the immune system and proves the role of local inflammatory-destructive processes in the pathogenesis of PES and glaucoma. The state of systemic cytokine profile in patients with PES and in combination with glaucoma showed an imbalance of interleukins, which was manifested by an increase the level of both pro-inflammatory cytokines (IL-6, IL-8) and anti-inflammatory cytokines (IL-4, IL-10).