ABSTRACT
PURPOSE: To evaluate the clinical significance of the data obtained during enzyme-linked immunosorbent assay (ELISA) of the blood serum of patients with inflammatory diseases of the anterior eye segment compared to a group of healthy volunteers. MATERIAL AND METHODS: A retrospective analysis of the results of serum ELISA of 200 patients with chronic keratoconjunctivitis and keratouveitis was performed using the solid-phase IFA method in order to detect the presence of antibodies to herpes simplex viruses of 1 and 2 types (HSV 1, 2), cytomegalovirus (CMV), Chlamydia trachomatis and Toxoplasma gondii. The control group consisted of 34 healthy volunteers with no signs of inflammation of the eye tissue. RESULTS: There were no significant differences in the frequency of detection of both «acute-phase¼ IgM and «chronic¼ IgG to HSV and CMV between patients of the main group and healthy volunteers (ρ≥0.05). The levels of IgG to Toxoplasma gondii in the study group were three times higher than in the control group (ρ≤0.05). A comparative analysis of the frequency of detection of antibodies to Chlamydia trachomatis showed statistically significant differences between the groups and more frequent detection of immunoglobulins classes A, G and M in patients with inflammatory eye diseases (ρ≤0.05). CONCLUSIONS: The absence of statistical differences with the control group in the frequency of detection of active HSV and CMV infections in patients with inflammatory diseases of the anterior eye segment when using ELISA allows to recommend the use of additional methods of examination such as polymerase chain reaction (PCR) and real-time PCR (RT-PCR) with identification of pathogen genetic material in the available biological secretions. The increase in IgG titers to toxoplasma in patients of the main group apparently indicates a cross-stimulation of antibody synthesis against the background of a chronic inflammatory process. Significant differences in the frequency of detection of all types of antibodies to chlamydiae suggests a significant etiological role of this pathogen in the development and maintenance of chronic inflammation in the anterior eye segment.
Subject(s)
Eye Infections , Antibodies, Viral , Cytomegalovirus , Enzyme-Linked Immunosorbent Assay , Humans , Retrospective StudiesABSTRACT
In recent years, all medical specialists, including ophthalmologists, have been facing the problem of mixed infections. Recurrent inflammation in the anterior and posterior eye segments is often a result of infection by more than one variety of pathogens. MATERIAL AND METHODS: Over the period 2013-2016, 34 patients (14 men and 20 women) with different inflammatory processes in the eye who appeared DNA-positive for mycoplasmas (Mycoplasma hominis, Ureaplasma urealyticum) and/or chlamydiae (Chlamydia trachomatis) (PCR testing of tear fluid and/or urine) were followed up. All patients were examined for intensive production of herpesvirus, adenovirus, and enterovirus DNA in biological fluids. After being consulted by related specialists, all the patients started local and systemic (antibacterial and antiviral) therapy. In the end of the latter, laboratory tests were repeated. RESULTS: Among all the clinical forms, anterior segment inflammation (i.e. of conjunctiva, cornea, and the anterior vascular tract) prevailed - 76%. In most patients, mycoplasmas and/or chlamydiae formed associations with herpesviruses (n=19; 56%). Bacterial DNA alone (mycoplasma and/or chlamydia) was detected in 12 cases (35%). In 4 cases, mycoplasma and/or chlamydia DNA was detected in tear fluid, in 19 patients - in urine, and in 10 patients - in both secreta. Local and systemic causal treatment enabled resolution of the complaints and symptoms and yielded negative results of follow-up laboratory tests. CONCLUSION: More than a half of the patients demonstrated concomitant viral-bacterial infection (22 cases). The presence of bacterial/viral DNA in biological secreta, as revealed by PCR, reflects the systemic nature of the infection process and, thus, necessitates engagement of related specialists (dermatologists, urologists, gynecologists).
