Differential Proteins Expression Distinguished Between Patients With Infectious and Noninfectious Uveitis.

PURPOSE: We investigated the aqueous humor proteome and associated plasma proteome in patients with infectious or noninfectious uveitis. METHODS: AH and plasma were obtained from 28 patients with infectious uveitis (IU), 29 patients with noninfectious uveitis (NIU) and 35 healthy controls undergoing cataract surgery. The proteins profile was analyzed by SomaScan technology. RESULTS: We found 1844 and 2484 proteins up-regulated and 124 and 161 proteins down-regulated in the AH from IU and NIU groups, respectively. In the plasma, three proteins were up-regulated in NIU patients, and one and five proteins were down-regulated in the IU and NIU patients, respectively. The results of pathway enrichment analysis for both IU and NIU groups were related mostly to inflammatory and regulatory processes. CONCLUSION: SomaScan was able to detect novel AH and plasma protein biomarkers in IU and NIU patients. Also, the unique proteins found in both AH and plasma suggest a protein signature that could distinguish between infectious and noninfectious uveitis.

Immunogenicity of Adalimumab in Patients with Non-Infectious- Uveitis: Systematic Review and Meta-Analysis.

OBJECTIVE: To review the prevalence, incidence, and risk factors for developing anti-drug antibodies (AAA) in patients with non-infectious uveitis (NIU) treated with Adalimumab (ADA). METHODS: A systematic literature search was performed on PubMed, EMBASE, Virtual Health Library, Cochrane, and medRxiv. Meta-analysis was performed using random effects. RESULTS: Nine out of 2,373 studies were included. The prevalence of AAA in NIU patients treated with ADA was 9% (95% CI: 2% to 37%, I2 = 95% with a P<0.01), it was significantly higher in real-life scenarios (observational studies) than in clinical trials. The pooled incidence at 12 months was 27% (CI 95% 16%-42% I2 = 0%). Several factors have been associated with AAA generation in NIU patients, including the non-use of concomitant immunosuppressants, presence of autoimmune systemic disease, female gender, etc. CONCLUSION: This study showed that AAA prevalence is higher in real-life scenarios compared to clinical trials. Further research is needed to elucidate the factors that trigger AAA generation in NIU patients.

Recomendaciones médicas para uveítis no infecciosas en adultos

Justificación: Las uveítis no infecciosas constituyen una importante causa de pérdida visual a nivel mundial; por su complejidad y gravedad de complicaciones requieren un abordaje temprano y multidisciplinario. En Costa Rica se desconoce hasta el momento la incidencia global de estas entidades y todavía no existe ningún consenso en cuanto a su manejo. Objetivos: Resumir las recomendaciones terapéuticas vigentes para uveítis no infecciosas en adultos y ofrecer una guía adaptada a la realidad costarricense. Métodos: Se efectuó una revisión no sistemática de bibliografía médica indexada en las plataformas PubMed y Scielo, sobre el manejo médico de las uveítis no infecciosas. De igual manera, se compararon los esquemas terapéuticos recomendados actualmente en América y Europa con el abordaje realizado en los centros hospitalarios costarricenses, para crear una guía adaptada a la realidad nacional. En la elaboración de estas recomendaciones participaron médicos especialistas de todas las clínicas multidisciplinarias especializadas en uveítis del país. Conclusiones: En Costa Rica se cuenta con la mayoría de las opciones disponibles para el tratamiento de uveítis idiopáticas en el sistema público de salud. Se logró la creación de algoritmos de tratamiento para las diferentes patologías.

Summary Background: Noninfectious uveitis represents an important cause of visual loss worldwide, which in view of the severity and complexity of complications demands an early and multidisciplinary approach to therapy. In Costa Rica there is no statistical records of incidence nor consensus of management of these entities to this date. Objectives: To summarize the therapeutic recommendations for non-infectious uveítis according to the scientific evidence and adapt them to the Costa Rican conditions. Methods: A non-systematic review of medical literature indexed on PubMed and Scielo, concerning medical and surgical management of non-infectious uveitis was carried out. Likewise, the recommended therapeutic schemes in America and Europe were compared to the approach used in the Costa Rican hospital centers. In the elaboration of these recommendations participated physicians, specialists of all multidisciplinary clinics for uveitis of the country. Conclusions: In Costa Rica, the majority of alternatives available for the treatment of idiopathic uveitis in the public health system are available. It was possible to create therapeutic algorithms for the different diseases.

Molecular diagnosis of Ehrlichia canis infection in dogs with uveitis / Diagnóstico molecular da infecção por Ehrlichia canis em cães com uveíte

Canine monocytic ehrlichiosis (CME) is an infectious disease caused by a gram-negative bacterium Ehrlichia canis that has a high global prevalence that leads to high rates of morbidity and mortality in dogs. Among the clinical changes, ophthalmic diseases can lead to permanent blindness and it can be an important clinical sign. The objective of this study was to perform nested polymerase chain reaction (PCR) to diagnose E. canis infection in dogs with bilateral uveitis from the Veterinary Hospital of the Santa Cruz State University. Blood samples were collected and DNA for the molecular diagnosis was extracted from 66 adult dogs of both genders and mixed breeds diagnosed with bilateral uveitis. Thirty-five (53%) dogs showed positive results and presented with iridocyclitis, posterior uveitis, panuveitis, or uveitis with secondary glaucoma. This study demonstrates that nested PCR is an important tool for the differential diagnosis of dogs with bilateral uveitis, as it provides evidence of the infectious agent in the animal.(AU)

Erliquiose Monocítica Canina (EMC) é uma doença infecciosa causada por uma bactéria gram negativa da espécie Ehrlichia canis, que possui alta prevalência mundial e conduz a elevadas taxas de morbidade e mortalidade em cães. Dentre as alterações clínicas, as oftalmopatias podem levar a cegueira permanente e é ser um importante sinal clínico. Objetivou-se realizar nested-PCR para diagnosticar infecção por E. canis em cães portadores de uveíte bilateral provenientes da casuística do Hospital Veterinário da Universidade Estadual de Santa Cruz. Sessenta e seis cães adultos, de ambos sexos e raças variadas, diagnosticados com uveíte bilateral foram submetidos a coleta de sangue e o DNA para realização do diagnóstico molecular foi extraído destas amostras. Foram positivos no teste 35 (53%) cães, que apresentaram iridociclite, uveíte posterior, panuveíte ou uveíte com glaucoma secundário. Esse estudo demonstra a nested-PCR como ferramenta importante no diagnóstico diferencial de cães com uveíte bilateral, por proporcionar a comprovação do agente infeccioso no organismo do animal.(AU)

Molecular diagnosis of Ehrlichia canis infection in dogs with uveitis / Diagnóstico molecular da infecção por Ehrlichia canis em cães com uveíte

Canine monocytic ehrlichiosis (CME) is an infectious disease caused by a gram-negative bacterium Ehrlichia canis that has a high global prevalence that leads to high rates of morbidity and mortality in dogs. Among the clinical changes, ophthalmic diseases can lead to permanent blindness and it can be an important clinical sign. The objective of this study was to perform nested polymerase chain reaction (PCR) to diagnose E. canis infection in dogs with bilateral uveitis from the Veterinary Hospital of the Santa Cruz State University. Blood samples were collected and DNA for the molecular diagnosis was extracted from 66 adult dogs of both genders and mixed breeds diagnosed with bilateral uveitis. Thirty-five (53%) dogs showed positive results and presented with iridocyclitis, posterior uveitis, panuveitis, or uveitis with secondary glaucoma. This study demonstrates that nested PCR is an important tool for the differential diagnosis of dogs with bilateral uveitis, as it provides evidence of the infectious agent in the animal.

Erliquiose Monocítica Canina (EMC) é uma doença infecciosa causada por uma bactéria gram negativa da espécie Ehrlichia canis, que possui alta prevalência mundial e conduz a elevadas taxas de morbidade e mortalidade em cães. Dentre as alterações clínicas, as oftalmopatias podem levar a cegueira permanente e é ser um importante sinal clínico. Objetivou-se realizar nested-PCR para diagnosticar infecção por E. canis em cães portadores de uveíte bilateral provenientes da casuística do Hospital Veterinário da Universidade Estadual de Santa Cruz. Sessenta e seis cães adultos, de ambos sexos e raças variadas, diagnosticados com uveíte bilateral foram submetidos a coleta de sangue e o DNA para realização do diagnóstico molecular foi extraído destas amostras. Foram positivos no teste 35 (53%) cães, que apresentaram iridociclite, uveíte posterior, panuveíte ou uveíte com glaucoma secundário. Esse estudo demonstra a nested-PCR como ferramenta importante no diagnóstico diferencial de cães com uveíte bilateral, por proporcionar a comprovação do agente infeccioso no organismo do animal.

Striking Divergence in Toxoplasma ROP16 Nucleotide Sequences From Human and Meat Samples.

BACKGROUND: ROP16 is a protein kinase of Toxoplasma gondii identified in the mouse model as a virulent marker, but it is unknown whether this finding is relevant in human toxoplasmosis. METHODS: We obtained the Toxoplasma ROP16 locus DNA sequence in samples from 12 patients with ocular toxoplasmosis, 1 sample from a patient with congenital toxoplasmosis, 22 samples from soldiers operating in the jungle, 2 samples from urban soldiers, and 10 samples from meat for human consumption. An enzyme-linked immunosorbent assay specific for antibodies against the ROP16 mouse-virulent peptide was performed in 46 serum specimens from patients with ocular toxoplasmosis and in 28 serum specimens from patients with chronic asymptomatic infection, of whom 19 had congenital infection and 11 had toxoplasmic lymphadenitis. RESULTS: We found a striking divergence of the ROP16 nucleotide sequences. Ten of 12 sequences (83.3%) from patients with ocular toxoplasmosis clustered with those of mouse-virulent strains, whereas 7 of 7 ROP16 sequences (100%) from meat were clustered with those of mouse-avirulent strains. Only 11 of 104 serum specimens (10.5%) had specific antibodies against the mouse-virulent peptide, and there was no association between clinical forms and positive results of serological assays. CONCLUSIONS: The majority of ROP16 nucleotide sequences from Colombian patients with ocular toxoplasmosis belonged to the group of mouse-virulent strains.