Herpesvirus detection and cytokine levels (IL‐10, IL‐6, and IFN‐γ) in ocular fluid from Tunisian immunocompetent patients with uveitis

Abstract

Human herpesviruses (HHVs) are involved in the pathogenesis of different types of uveitis. Cytokine response plays an important role in virus-induced immunopathology. This study aimed to investigate the incidence of HHVs in aqueous humor samples of immunocompetent patients with suspected viral uveitis and cytokine (IL-10, IL-6, and IFN-γ) expression profiling. Forty-seven aqueous humor samples were collected from immunocompetent patients with viral uveitis. Samples were assayed for HHV-1 to HHV-8 by in-house real-time polymerase chain reactions. IL-6, IL-10, and IFN-γ were quantified with a cytometric bead array. Relations between viral detection, cytokine profiles, and clinical data were studied. At least one viral genome was detected in 21 aqueous humor samples analyzed. Varicella-zoster virus (VZV) was detected in 14 of the positive samples, cytomegalovirus (CMV) in 8, HSV-1 in 1, Epstein-Barr virus (EBV) in 4, and HHV-6 in 2. More than one viral genome was detected in seven aqueous humor samples. Aqueous humor samples positive for HHV-DNA contained significant levels of IL-6, IL-10, and IFN-γ, compared to HHV-DNA negative samples. High levels of IL-6 were detected in patients with CMV-DNA in their aqueous humor samples. Significantly higher levels of IL-10 and IFN-γ were found in positive samples for VZV, EBV, and HHV-6 DNA than in negative aqueous humor ones. VZV was the principal etiologic agent of uveitis in this Tunisian series, with CMV the second most common agent. Knowledge of immunoregulatory interactions and dynamic changes in viral uveitis may be a key to understand the pathogenesis leading to more-effective treatments.

Varicella zoster virus-associated morbidity and mortality in Africa – a systematic review

“…Although expensive and requiring greater technical expertise and resources, PCR tests, whether quantitative or qualitative, show superior sensitivity and specificity compared to antibody detection tests [ 27 ]. Of the eight studies that used PCR, three were quantitative [ 28 – 30 ], two qualitative [ 31 , 32 ], and the remaining three did not specify if the PCR used was quantitative or qualitative [ 33 – 35 ]. Four of the eight studies were performed on CSF (in patients that presented with signs of central nervous system [CNS] infections), whereas two studies were performed on ocular fluids (mostly from patients with uveitis).…”

“…The patients were highly immunosuppressed (median CD4 count was 89) and the case fatality rate for VZV CNS infections was 30.8% [ 32 ] [Siddiqi, personal communication, 13 October 2016]. In immunocompetent patients in Tunisia, 29.8% of uveitis cases were caused by VZV [ 30 ], while in South Africa, 32% of uveitis cases were caused by VZV [ 31 ].…”

Development of Extranodal NK/T-cell Lymphoma Nasal Type in Cerebrum Following Epstein-Barr Virus-positive Uveitis

“…Nahdi et al from Tunisia also reported that EBV DNA was positive in 19% (4/21) of the patients with uveitis, as determined by PCR of the vitreous fluid (21). These results suggest that the detection of EBV DNA in the vitreous fluid may not be rare in uveitis.…”

Immunopathology of Virus-Induced Anterior Uveitis

“…The AH of immunocompetent patients with HCMV anterior segment infections was reported to have significantly higher levels of IL-5, IL-6, IL-8 (CXCL8), monocyte chemotactic protein-1 (MCP-1; CCL-2), macrophage inhibitory protein-1β (MIP-1β; CCL-4), granulocyte colony stimulating factor, and transforming growth factor-β, but low levels of IL-2, IL-12, TNF-α, and INF-γ compared to the control groups. 48,49 Interestingly, no significant difference in aqueous cytokines was detected in HCMV qPCR-positive immunocompetent PSS patients when compared to HCMV qPCR-negative PSS patients. 49 Future studies are warranted to provide better insights into the inflammatory response or intraocular milieu that may potentiate HCMV anterior segment infection.…”