CHEMOKINES IN ACUTE ANTERIOR UVEITIS

Purpose. The aim of this study was to define the expression of chemoat tractant cytokines (chemokines) in human aqueous humor, obtained from patients with idiopathic acute anterior uveitis (AU). The chemokines a ssayed included macrophage inflammatory proteins-1 alpha and -1 beta ( MLP-1 alpha and -1 beta), monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), interferon-inducible protein-10 (IP-10), and reg ulated on activation, normal T-expressed and secreted (RANTES). Method s. We studied fifteen patients (7 females) with idiopathic acute AU, a t various stages of disease activity, and two control subjects undergo ing elective cataract extraction, Aqueous humor was collected under as eptic conditions, after obtaining informed consent. Chemokine concentr ations were measured using specific ELISA. Correlation was sought betw een chemokine concentrations and disease activity, evaluated by slit l amp biomicroscopy and graded using a standardized scale of disease sev erity. Results. IL-8 was detected (35.9 +/- 13.6, mean +/- SE) in thrr e of seven subjectes in active, untreated stages of AU (clinical score 2-4), and it was undetectable in subjects sampled in the quiescent ph ase of the disease. IP-10 had a mean concentration of 40.6 ng/ml +/- 2 0.9 in the active group (N = 7), declining to 0.8 ng/ml +/- 0.3 in the samples from patients with inactive disease (N = 7, P = 0.001). Simil arly, substantial expression of MCP-1 was noted, with a maximum concen tration of 145 ng/ml, in acute (active) AU (N = 6), (26.7 +/- 19.7), f alling to undetectable levels in those with inactive disease, and in c ontrol subjects (P = 0.001). MIP-1 beta (N = 7), (3.3 +/- 1.5, P = 0.0 01) and RANTES (N = 7, 8.8 +/- 4.2) levels were significantly increase d in acute disease (P = 0.001) and related to the activity of the dise ase, although the concentrations were not as high as MCP-1, IP-10 and IL-8. IF-10, RANTES and MIP-1 beta were detected at low concentrations in the aqueous humor of the control subjects. Conclusions. This is th e first study of chemokine concentrations in the aqueous humor of pati ents with acute anterior uveitis. The concentration of chemokines: IL- 8, IP-IO, MCP-1, RANTES and MIP-1 beta were significantly increased du ring the active stages of AU, and correlated with the clinical severit y of the disease. These chemoattractant cytokines probably play a crit ical role in leucocyte recruitment in acute AU.