Keywords
noninfectious uveitis
cellular immunity
humoral immunity
correction principles
immunological disorders
How to Cite
Abstract
Background. The role of immunological disorders in the pathogenesis of uveitis has been proven by numerous studies. However, there are different views on the timing and methods of immunocorrection. In our opinion, this issue should be solved on the basis of determining the mechanisms of the formation of immunodeficiency states in uveitis.
The purpose of this work was to develop a classification of secondary immunodeficiency states in uveitis according to the mechanism of formation.
Materials and Methods. The paper presents the results of the examination of 370 patients with uveitis (416 eyes; 179 were men, 191 were women, aged from 16 to 87 years; the duration of the disease ranged from 1 month to 32 years) who were treated in Kharkiv Regional Clinical Hospital, were under dispensary supervision at Kharkiv Regional Anti-Tuberculosis Dispensary and Kharkiv Regional Dispensary for Radiation Protection of the Population, or were examined, consulted and treated on an outpatient basis. The observation period was up to five years.
Results. Based on the study of immunological changes in patients with uveitis, the dynamics of immunological disorders in relapses of the inflammatory process in the uveal tract, clinical and immunological features of various forms of uveitis, and the results of correction of immunological disorders in patients with uveitis, a classification of secondary immunodeficiency states in uveitis according to the mechanism of their formation was proposed. On its basis, the principles of correction of immunodeficiency states in patients with uveitis were developed.
Keywords: infectious uveitis, noninfectious uveitis, cellular immunity, humoral immunity, correction principles, immunological disorders.
References
Wu X, Tao M, Zhu L, Zhang T, Zhang M. Pathogenesis and current therapies for non-infectious uveitis. Clin Exp Med. 2023;23(4):1089-06. DOI: 10.1007/s10238-022-00954-6. PMID: 36422739.
Barros Ferreira L, Ashander LM, Ma Y, Appukuttan B, Williams KA, Best G, Smith JR. Effects of tumor necrosis factor-α and interleukin-1β on human retinal endothelial cells. Cytokine. 2024;173:156407. DOI: 10.1016/j.cyto.2023.156407. PMID: 37924741.
Zhang J, Kamoi K, Zong Y, Yang M, Ohno-Matsui K. Cytomegalovirus Anterior Uveitis: Clinical Manifestations, Diagnosis, Treatment, and Immunological Mechanisms. Viruses. 2023;15(1):185. DOI: 10.3390/v15010185. PMID: 36680225.
Panchenko NV, Samofalova MN, Friantseva MV. Anti-inflammatory cytokines content in different clinical uveitis course complicated by the optic nerve inflammation. J. ophthalmol. (Ukraine). 2016;(1):24-6. DOI: 10.31288/oftalmolzh201612426.
Panchenko MV, Nikolaienko MM, Honchar OM, Prykhodko DO, Pereiaslova HS, Sokol OO. Serum TNF-α and IL-1β levels in patients with RNFL thinning in uveitis complicated by optic nerve inflammation. J. ophthalmol. (Ukraine). 2020;(6):14-8. DOI: 10.31288/oftalmolzh202061418.
Zhang T, Han X, Zhong Y, Kam HT, Qiao D, Chen Z, et al. Regulatory T cell intravitreal delivery using hyaluronan methylcellulose hydrogel improves therapeutic efficacy in experimental autoimmune uveitis. Biomater Adv. 2023;151:213496. DOI: 10.1016/j.bioadv.2023.213496. PMID: 37290283.
Choi JK, Egwuagu CE. Analysis of Regulatory B Cells in Experimental Autoimmune Uveitis. Methods Mol Biol. 2021;2270:437-50. DOI: 10.1007/978-1-0716-1237-8_23. PMID: 33479912.
Panchenko NV, Samofalova MN, Gonchar EN, Prykhodko DO, Arustamova GS, Lytvyshchenko AV. Alterations in the expression of tumor necrosis factor-alpha in the uveitis with optic nerve inflammation. J. ophthalmol. (Ukraine). 2016;(5):18-21. DOI: 10.31288/oftalmolzh201651821.
Maria DM, Ulrike K, Gerhild W. The immunopathogenesis of chronic and relapsing autoimmune uveitis – Lessons from experimental rat models. Prog Retin Eye Res. 2018;65:107-26. DOI: 10.1016/j.preteyeres.2018.02.003. PMID: 29496590.
Putera I, Schrijver B, Ten Berge JCEM, Gupta V, La Distia Nora R, Agrawal R, et al. The immune response in tubercular uveitis and its implications for treatment: From anti-tubercular treatment to host-directed therapies. Prog Retin Eye Res. 2023;95:101189. DOI: 10.1016/j.preteyeres.2023.101189. PMID: 37236420.
Penkov MA, Zubarev SF, Avrushchenko NM, Panchenko NV. Comparative assessment of clinical effectivity of immunocorrecting therapy using thymoptin, T-activin and decaris in treatment of patients with endogenous uveitis. J. ophthalmol. (Ukraine). 1993;48(1):31-5.
Iwahashi C, Fujimoto M, Nomura S, Serada S, Nakai K, Ohguro N, et al. CTLA4-Ig suppresses development of experimental autoimmune uveitis in the induction and effector phases: Comparison with blockade of interleukin-6. Exp Eye Res. 2015;140:53-64. DOI: 10.1016/j.exer.2015.08.012. PMID: 26297802.
Velazquez-Villoria D, Macia-Badia C, Segura-Garcia A, Pastor Idoate S, Arcos-Algaba G, Velez-Escola L, Garcia-Arumi J. Efficacy of immunomodulatory therapy with interferon-β or glatiramer acetate on multiple sclerosis-associated uveitis. Arch Soc Esp Oftalmol. 2017;92(6):273-9. DOI: 10.1016/j.oftal.2016.11.018. PMID: 28188020.
Degtyarenko TV. Modern approaches to immunorehabilitation of patients with ophthalmopathology. J. ophthalmol. (Ukraine). 1992;5-6:332-5.
Garcia-Geremias M, Carreno E, Epps SJ, Lee RW, Dick AD. Clinical outcomes of intravenous immunoglobulin therapy in refractory uveitis. Int Ophthalmol. 2015;35(2):281-5. DOI: 10.1007/s10792-015-0051-0. PMID: 25708281.
Wechsler B, Le Thi Huong DU, Godeau P. Medical treatment of Behcet's disease. J Mal Vasc. 1988;13(3):262-9. PMID: 3049885.
Li S, Liu F, Zhang K, Tong Y, Liu X. Research Progress on the Mechanism of Natural Product Ingredients in the Treatment of Uveitis. J Immunol Res. 2021;2021:6683411. DOI: 10.1155/2021/6683411. PMID: 34778467.
Kaburaki T, Zhang Q, Jin X, Uchiyama M, Fujino Y, Nakahara H, et al. Effects of Japanese herbal medicine Sairei-to on murine experimental autoimmune uveitis. Graefes Arch Clin Exp Ophthalmol. 2013;251(12):2733-9. DOI: 10.1007/s00417-013-2473-6. PMID: 24126677.
Heidarian M, Jensen IJ, Kannan SK, Pewe LL, Hassert M, Park S, et al. Sublethal whole-body irradiation induces permanent loss and dysfunction in pathogen-specific circulating memory CD8 T cell populations. Proc Natl Acad Sci U S A. 2023;120(27):e2302785120. DOI: 10.1073/pnas.2302785120. PMID: 37364124.
Standish LJ, Torkelson C, Hamill FA, Yim D, Hill-Force A, Fitzpatrick A, et al. Immune defects in breast cancer patients after radiotherapy. J Soc Integr Oncol. 2008;6(3):110-21. DOI: 10.2310/7200.2008.0018. PMID: 19087768.
Yamaoka M, Kusunoki Y, Kasagi F, Hayashi T, Nakachi K, Kyoizumi S. Decreases in percentages of naïve CD4 and CD8 T cells and increases in percentages of memory CD8 T-cell subsets in the peripheral blood lymphocyte populations of A-bomb survivors. Radiat Res. 2004;161(3):290-8. DOI: 10.1667/rr3143. PMID: 14982485.
Chinen J, Shearer WT. Secondary immunodeficiencies, including HIV infection. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S195-203. DOI: 10.1016/j.jaci.2009.08.040. PMID: 20042227.
Srivastava S, Wood P. Secondary antibody deficiency - causes and approach to diagnosis. Clin Med (Lond). 2016;16(6):571-6. DOI: 10.7861/clinmedicine.16-6-571. PMID: 27927823.
Panchenko HY. Correction of cellular immunity disorders in patients with chronic hepatitis. Bulletin of problems of modern medicine. 1993;1:28-30.
Daoud AK, Tayyar MA, Fouda IM, Harfeil NA. Effects of diabetes mellitus vs. in vitro hyperglycemia on select immune cell functions. J Immunotoxicol. 2009;6(1):36-41. DOI: 10.1080/15476910802604564. PMID: 19519161.
Shpak NI, Savko VV. [Basic principles for the diagnosis and treatment of patients with endogenous uveitis]. Oftalmol J. 1986;(2):65-7. PMID: 3714178.
Martenet AC. Application en thérapeutique oculaire des connaissances actuelles de l'immunologie [Application of current immunological knowledge in ocular therapy]. Klin Monbl Augenheilkd [Clinical Monthly Newsletters for Ophthalmology]. 1985;186(6):428-33. DOI: 10.1055/s-2008-1050951. PMID: 4046449.
Roberge FG, de Smet MD, Benichou J, Kriete MF, Raber J, Hakimi J. Treatment of uveitis with recombinant human interleukin – 13. Brit. J. Ophthalmol. 1998;82(10):1195-8. DOI: 10.1136/bjo.82.10.1195. PMID:9924310.
Hadjadj J, Dechartres A, Chapron T, Assala M, Salah S, Dunogue B, et al. Relevance of diagnostic investigations in patients with uveitis: Retrospective cohort study on 300 patients. Autoimmun Rev. 2017;16(5):504-11. DOI: 10.1016/j.autrev.2017.03.006. PMID: 28279837.
Ferrara M, Eggenschwiler L, Stephenson A, Montieth A, Nakhoul N, Araujo-Miranda R, Foster CS. The Challenge of Pediatric Uveitis: Tetriary Referral Center Experience in the United States. Ocul Immunol Inflamm. 2019;27(3):410-7. DOI: 10.1080/09273948.2017.1420202. PMID: 29333911.
Bosch-Driessen EH, Rothova A. Recurrent ocular disease in postnatally acquired toxoplasmosis. Am J Ophthalmol. 1999;128(4):421-5. DOI: 10.1016/s0002-9394(99)00271-8. PMID: 10577582.
Yang M, Kamoi K, Zong Y, Zhang J, Ohno-Matsui K. Human Immunodeficiency Virus and Uveitis. Viruses. 2023;15(2):444. DOI: 10.3390/v15020444. PMID: 36851658.
Terada Y, Miyata K, Shoji N, Mochizuki M. Human T-cell Leukemia Virus Type 1 (HTLV-1)-induced Uveitis. Ocul Immunol Inflamm. 2023;31(7):1416-24. DOI: 10.1080/09273948.2023.2175697. PMID: 36803501.
Mochizuki M, Tajima K, Watanabe T, Yamaguchi K. Human T lymphotropic virus type 1 uveitis. Br J Ophthalmol. 1994;78(2):149-54. DOI: 10.1136/bjo.78.2.149. PMID: 8123625.
Towler H. Retroviruses – a clue to autoimmunity? Br J Ophthalmol. 1994;78(3):161-2. DOI: 10.1136/bjo.78.3.161. PMID: 8148328.
Davey MP, Rosenbaum JT. The human leukocyte antigen complex and chronic ocular inflammatory disorders. Am J Ophthalmol. 2000;129(2):235-43. DOI: 10.1016/s0002-9394(99)00433-x. PMID: 10682977.
Schwartz R.H. Functional properties of I region gene products and theories of immune response (Ir) gene function. Ia Antigens. 1982;1:161-218.
Campochiaro PA, Lim JI. Aminoglycoside toxicity in the treatment of endophthalmitis. The Aminoglycoside Toxicity Study Group. Arch Ophthalmol. 1994;112(1):48-53. DOI: 10.1001/archopht.1994.01090130058017. PMID: 8285892.
Bosch-Driessen EH, Lardy NM, Rothova A. Antinuclear antibody and HLA-B27 positive uveitis: combination of two diseases? Br J Ophthalmol. 1997;81(9):771-3. DOI: 10.1136/bjo.81.9.771. PMID: 9422931.
Toledo de Abreu M, Belfort R Jr, Matheus PC, Santos LM, Scheinberg MA. T-lymphocyte subsets in the aqueous humor and peripheral blood of patients with acute untreated uveitis. Am J Ophthalmol. 1984;98(1):62-5. DOI: 10.1016/0002-9394(84)90189-2. PMID: 6234809.
Deschenes J, Freeman WR, Char DH, Garovoy MR. Lymphocyte subpopulations in uveitis. Arch Ophthalmol. 1986;104(2):233-6. DOI: 10.1001/archopht.1986.01050140087026. PMID: 2936325.
Hamel CP, De Luca H, Billotte C, Offret H, Bloch-Michel E. Nonspecific immunoglobulin E in aqueous humor: evaluation in uveitis. Graefes Arch Clin Exp Ophthalmol. 1989;227(5):489-93. DOI: 10.1007/BF02172904. PMID: 2806935.
Ronday MJ, Ongkosuwito JV, Rothova A, Kijlstra A. Intraocular anti-Toxoplasma gondii IgA antibody production in patients with ocular toxoplasmosis. Am J Ophthalmol. 1999;127(3):294-300. DOI: 10.1016/s0002-9394(98)00337-7. PMID: 10088739.
Deschenes J, Char DH, Kaleta S. Activated T lymphocytes in uveitis. Br J Ophthalmol. 1988;72(2):83-7. DOI: 10.1136/bjo.72.2.83. PMID: 2964862.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.