Aqueous Humor Cytokine Response in the Contralateral Eye after First-Eye Cataract Surgery in Patients with Primary Angle-Closure Glaucoma, High Myopia or Type 2 Diabetes Mellitus

Abstract

Background: Bilateral sequential cataract surgery within a short period is becoming more prevalent because of the efficiency and safety of modern cataract surgery. It has been reported that the first surgical eye might affect the contralateral eye. This study investigated the cytokines involved in the immunopathogenesis of pre-existing ocular or systemic conditions, as well as the inflammatory biomarkers in response to topical stimuli, by analyzing the cytokine profile of aqueous humor (AH) from cataract patients without these morbidities as control and with type 2 diabetes mellitus (DM), primary angle-closure glaucoma (PACG) or high myopia (HM) in each eye at the beginning of first (defined as baseline) and second eye cataract surgery. Methods: Forty patients were recruited in this cohort study (10/group). Bilateral sequential cataract surgeries were conducted at intervals of 12.08 ± 1.2 days. Aqueous humor samples (100-200 µL/eye) were separately collected from 40 first-eyes and 40 second-eyes at the beginning of the cataract surgeries. Twenty-seven selected cytokines were detected with Luminex-multiplex immunoassay. The concentrations of cytokines in the aqueous humor and their association with pre-existing ocular or systemic conditions were analyzed and compared between and within the groups. Results: Before first-eye surgery (baseline), the levels of interleukin (IL)-1ra, IL-13 and tumor necrosis factor (TNF)-alpha were significantly increased in PACG compared with controls. The levels of IL-13 were increased while that of IL-15 were decreased in HM. Compared with controls, 11 cytokines were significantly increased in DM. In the AH of the contralateral eye after first-eye cataract surgery, basic fibroblast growth factor (bFGF) was significantly more abundant in PACG and HM, while the levels of monocyte chemoattractant protein-1 (MCP-1) and interferon gamma-induced protein 10 (IP-10) were decreased in PACG. We also identified 6 significantly upregulated cytokines in DM compared with controls. Compared with baseline, there was an overlap of 5 altered cytokines in the AH of contralateral eyes after firsteye surgery between the four groups. Some were exclusively altered in each subgroup, with 1 in the control group, 4 cytokines in the PACG and HM groups, and none in the DM group. Conclusions: From the initial profile, it is observed that patients with pre-existing ocular or systemic conditions have some degree of inflammation in their eyes before surgery and in the contralateral eye after the first eye cataract surgery, which could be peculiar of the morbid conditions of the patients. Inflammation was more detectable in patients with type 2 DM before surgery. PACG and HM patients showed stronger intraocular inflammatory reactions to topical stimuli compared with controls and DM patients. Our data suggest that ophthalmologists should pay closer attention to inflammatory responses, especially in cataract patients with pre-existing conditions, although the clinical significance of these changes following surgery re...

Changes in AH cytokines and metabolomics in contralateral eyes of ARC patients following unilateral surgery reveal effects on the contralateral eye's intraocular environment stability

“…Through the analysis of aqueous humor in patients with diabetes, high myopia, and primary angle-closure glaucoma, Jiancen Tang and colleagues discovered that IL-2 levels in the aqueous humor of the contralateral eye increased compared to the preoperative levels in the operated eye after surgery. This phenomenon was also con rmed in our animal experiments [30] .It is well known that IL-2, produced by T cells, is an immunoregulatory protein. IL-2 plays a crucial role in regulating the immune system, particularly in the proliferation, differentiation, and function of T cells.…”

“…Interestingly, in recent years, more and more teams have found that in non-diabetic patients, the aforementioned phenomenon and high expression of biological factors such as MCP-1 do not exist [28,29] .In diabetic patients, there is a signi cant increase in MCP-1 and substance P in the second eye [28,29] . Furthermore, when different diseases are combined, the expression of biological factors in the aqueous humor before and after surgery varies among patients [30] .Therefore, in patients with systemic diseases, there are inherent differences in the AH environment.…”

Human Plasma IgG N -Glycome Profiles Reveal a Proinflammatory Phenotype in Chronic Thromboembolic Pulmonary Hypertension

“…IgG N-glycome profiling by matrix-assisted laser desorption/ ionization time of flight mass spectrometry, raw matrix-assisted laser desorption/ionization time of flight mass spectrometry data processing, and circulating inflammatory markers measurement (cytokine assay) were conducted according to previous reports 16,[20][21][22][23] and are described in detail in the Supplemental Material.…”

Clonal Hematopoiesis of Indeterminate Potential in Chronic Thromboembolic Pulmonary Hypertension: A Multicenter Study

“…Inflammatory marker measurements were performed without knowledge of the CHIP status of the patients. Profiling of the inflammatory marker of circulating cytokines and IgG galactosylation (IgG-Gal) ratio was performed according to published protocols, [27][28][29] detailed methods were in Supplemental Material.…”