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@#AIM: To detect the expression of erythropoietin(EPO)and hypoxia-inducible factor-1α(HIF-1α)in serum and aqueous humor of patients with acute anterior uveitis(AAU), and to explore their clinical significance. <p>METHODS: From January 2018 to December 2020, 60 patients with AAU in our hospital were prospectively selected as the research objects, and 60 patients with proliferative vitreoretinopathy in the same period were taken as control(control group). The serum and aqueous humor of two groups were collected, enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of EPO and HIF-1α in serum and aqueous humor; the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS)were used to evaluate the AAU patients, and the severity of the disease was scored; Pearson method was used to analyze the correlation between SAS score, SDS score and levels of EPO and HIF-1α in serum and aqueous humor, and the correlation between levels of EPO and HIF-1α in the serum and aqueous humor. Spearman was used to analyze the correlation between the disease severity score of AAU patients and the levels of EPO and HIF-1α in serum and aqueous humor. <p>RESULTS: Compared with the control group, the levels of EPO and HIF-1α in the serum and aqueous humor of the study group were higher(<i>P</i><0.01). Among AAU patients, 23 were negative of SAS score and 37 were positive, and 29 were negative of SDS score and 31 were positive. Compared with patients with negative SAS score, the level of HIF-1α in serum and the level of EPO in the aqueous humor were higher in patients with positive SAS score(<i>P</i><0.05); compared with patients with negative SDS score, the level of EPO in serum and the levels of EPO and HIF-1α in aqueous humor were higher in patients with positive SDS score(<i>P</i><0.01). There were 26 mild patients and 34 severe patients with AAU. Compared with mild patients with AAU, the levels of EPO and HIF-1α in serum and aqueous humor were increased in severe patients(<i>P</i><0.01). Pearson analysis showed that the SAS and SDS scores of AAU patients were not significantly correlated with the levels of EPO and HIF-1α in serum and aqueous humor(<i>P</i>>0.05), there was a positive correlation between EPO and HIF-1α in serum(<i>P</i><0.05), and between EPO and HIF-1α in aqueous humor(<i>P</i><0.05). Spearman analysis showed that the disease severity score of AAU patients was positively correlated with the levels of EPO and HIF-1α in serum and aqueous humor(<i>P</i><0.05). <p>CONCLUSION: EPO and HIF-1α are highly expressed in serum and aqueous humor of AAU patients, and they are closely related. The two are closely related to the disease severity score, and should be paid attention to clinically.
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@#AIM: To study the changes of serum IL-35 and TGF-β1 expression levels and the correlation between them in patients with acute anterior uveitis, and to explore the clinical significance of IL-35 and TGF-β1 levels in patients with acute anterior uveitis.<p>METHODS: Thirty patients with acute anterior uveitis confirmed in the Department of Ophthalmology of Gansu Provincial Hospital into 2018-05/2019-05 were selected as the case group, and thirty healthy patients who received physical examination at the Gansu Provincial Hospital during the same period were selected as the control group. Serum IL-35 and TGF-β1 expression levels between the two groups were detected by Elisa. Modified endotoxin-induced uveitis(EIU)clinical standard was used for the severity of acute anterior uveitis. <p>RESULTS: Serum IL-35 and TGF-β1 expression levels in the acute anterior uveitis group were significantly higher than that in the healthy control group(all<i> P</i><0.05), and there was no significant correlation between serum IL-35 and TGF-β1 levels as well as the severity of acute anterior uveitis(<i>r</i>s=0.087, 0.044, all<i> P</i>>0.05). There was a significant positive correlation between serum IL-35 and TGF-β1 expression levels in patients with acute anterior uveitis(<i>r</i>s=0.637, <i>P</i><0.001).<p>CONCLUSION: The expression levels of IL-35 and TGF-β1 in serum are closely related to the occurrence and development of acute anterior uveitis and may play a synergistic role in immunosuppression in acute anterior uveitis.
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Objective To observe and compare the effect of lyceum barbarum combined with corticosteroids and corticosteroids alone on the treatment of acute anterior uveitis(AAU), to explore the mechanism of lyceum barbarum could auxiliary treat AAU.Methods 60 cases with AAU were randomly divided into lyceum barbarum combined with corticosteroids treatment group(combination therapy group), simple corticosteroids treatment group(cortisol treatment group) and health control group.Health control group consists of healthy volunteers.Results The efficient rate of the combination therapy group in the early treatment stage(1 week) was 86%, the cortisol treatment group was 62%.In the late stage treatment(2 weeks) the efficient rate was 98% and 80% in the cortisol treatment group.The total efficiency rate in the two groups was significant difference(P<0.05).The level of IL-10、TNF-α、 IFN-γ and IL-23 in the combination therapy group and cortisol treatment group were significantly higher than those in healthy control group in AAU attack period(P<0.01), the levels of these cytokines were significantly decreased after treatment(P<0.01).IL-10 was significantly higher in patients before treatment than that in healthy control group(P<0.01), IL-10 in cortisol treatment group was increased than that before treatment, IL-10 in combination therapy group was decreased after treatment than that before treatment(P<0.05).The level of IFN-γ in the combination therapy group and cortisol treatment group were higher than that in healthy control group after treatment(P<0.05).Conclusion The levels of IFN-γ, IL-10, TNF-α, IL-23 in acute attack stage in AAU patients were significantly higher than those after treatment and other people with physical examination, while the treatment of lyceum barbarum combined with hormone, IFN-γ and IL-23 levels decreased significantly, the effect was obvious, which is worthy of promotion.
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PURPOSE: Intravitreal injection of bevacizumab (Avastin(R)) can lead to several intraocular complications including endophthalmitis, hemorrhage and inflammation. We present one case of acute anterior uveitis with hypopyon in an HLA-B27(+) patient following intravitreal injection of bevacizumab. CASE SUMMARY: A 40-year-old male with known central retinal vein occlusion presented with redness and decreased visual acuity in the left eye. Symptoms had developed 4 days earlier after the sixth intravitreal injection of bevacizumab in that eye. The patient had a marked anterior chamber reaction with hypopyon and posterior synechiae. Nine days after onset, similar symptoms in the left eye occurred in the uninjected right eye. Through examination and clinical manifestations, we diagnosed acute anterior uveitis associated with HLA-B27 positivity. The patient was treated with 1% prednisolone acetate, 0.5% moxifloxacin and 1% atropine in both eyes and all symptoms had resolved after 6 weeks.
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Adulto , Humanos , Masculino , Cámara Anterior , Atropina , Endoftalmitis , Hemorragia , Antígeno HLA-B27 , Inflamación , Inyecciones Intravítreas , Prednisolona , Vena Retiniana , Uveítis Anterior , Agudeza Visual , BevacizumabRESUMEN
Background Human leucocyte antigen (HLA)-B27-associated uveitis is one of the most common causes of non-infectious uveitis.T helper 17 (Th17) cells play an important role in human autoimmune diseases,but the pathology research on the production of Th17 cells in acute anterior uveitis patients positive for HLA-B27 was rarely reported.Objective The aim of this study was to investigate the expression and significance of the peripheral blood T helper cell subsets (Th1,Th2,Th17) in acute anterior uveitis patients positive for HLA-B27.Methods This study meets the criteria of the Helsinki Declaration.Informed consent was obtained from all the participants.A prospective cohort design was used in this study.Twenty-two patients with acute anterior uveitis positive for HLA-B27 were enrolled from Affiliated Second Hospital of Nanjing Medical University,and 16 normal healthy subjects with matched gender and age were enrolled as controls.The expression of interferon-γ (IFN-γ),interleukin-4 (IL-4) and IL-17 on lymphocytes (CD4+) in blood were assessed by flow cytometry,and immunoturbidimetry was used to detect the C reactive protein (CRP) level in blood.The degree of the severity of disease was evaluated by clinical scoring.The correlations between the percentage of IFN-γ+Th1,IL-4+Th2,or IL-17+Th17 with clinical factors and CRP were analyzed.Results The percentages of IFN-γ+Th1 and IL-17+Th17 in the peripheral blood were (23.11 ±9.69) ％ and (3.96±2.92) ％ in the patient group,showing a significant increase in comparison with (16.00±4.26)％ and (1.68±0.60) ％ in the control group (P=0.041,P=0.002).However,the IL-4+Th2 level was not significantly different between the patient group (0.33％ ±0.36％) and the control group (0.56％ ±0.34％) (P=0.122).No significant correlations were found between the percentage of IFN-γ+ Th1 with disease severity and CRP (r =0.197,P =0.500 ; r =0.253,P =0.383),between the percentage of IL-4+ Th2 with disease severity and CRP (r =0.068,P =0.817 ; r =0.439,P =0.116) as well as between the percentage of IL-17 + Th17 with CRP (r =0.226,P =0.436).However,a positive correlation was seen between the percentage of IL-17+ Th17 with disease severity (r =0.805,P =0.001).Conclusions IFN-γ and IL-17 in human CD4+T cells are significantly elevated in the blood of HLA-B27-related acute anterior uveitis patients.Disease severity is associated with the percentage of IL-17 +Th17,suggesting that Th1 cells together with Th17 cells participate in the pathogenesis of the disease and Th17 cells might play a dominant role in the disease.
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In order to evaluate association of particular HLA typing with certain uveitis in Korean population, HLA antigens were analyzed in 114 uneitis patients(acute anterior uveitis: 32 cases, Behcet`s disease: 25 cases, intermediate uveitis: 19 cases, Vogt-Koyanagi-Harada (V-K-H) syndrome: 10 cases, retinal vasculitis: 12 cases, Eale`s disease: 3 cases, posterior uveitis: 9 cases, pan.uveitis: 4 cases). The stronger association between acute anterior uveitis and HLA-B27 was statistically significant, and this result was similar to reports in other ethnic groups. Also, the association between V-K-H syndrome and HLA-DR4 showed same results. But the high frequency of HLA-DR7 in the patients with V-K-H syndrome was unque in patients of Korean popjlation and statistically significant. The association between HLA-A2 and posterior uveitis was high in patients of Korean population and statistically significant. Behcet`s disease was stronger association with HLA-B51 but not statistically significant and much weaker association than reports in Japanese group. Although many similarities of associations between particular uveitis and HLA typing were detected as compared with other ethnic groups, distinctive HLA associations were demonstrated in Korean population. Additional cases and long-term follow-up are required to confirm the association with HLA typing and the relationship with prognosis including clinical and laboratory variabilities.