Intraocular Cytokine Environment in Active Behçet Uveitis

Purpose

To determine cytokine profiles in aqueous humor and peripheral blood from patients with Behçet uveitis.

Design

Prospective, experimental, and case-control study.

Methods

Aqueous humor and peripheral blood samples from 24 patients with Behçet uveitis, 28 patients with other causes of endogenous uveitis, and 20 healthy subjects after uncomplicated cataract surgery were obtained. Cytokines (interferon gamma (IFN-γ), interleukin [IL]-2, IL-4, IL-10, IL-12, IL-15, and tumor necrosis factor alpha (TNF-α)) were measured by enzyme-linked immunosorbent assay and compared between the uveitis groups.

Results

Aqueous interferon gamma (IFN-γ) levels were higher in patients with Behçet uveitis in contrast to higher concentrations of IL-4 in patients without Behçet uveitis. Aqueous levels of tumor necrosis factor alpha (TNF-α) were higher in patients with Behçet uveitis than in patients without Behçet uveitis. Aqueous and serum IL-10 were detected in all patients without Behçet uveitis, but were below detection limits in all patients with Behçet uveitis. Furthermore, IL-15 was exclusively increased in the aqueous humor of Behçet uveitis. The aqueous IL-2 or IL-12 levels were similar regardless of the presence of Behçet uveitis.

Conclusions

Our results showed that an extreme Th1 polarization, a high proinflammatory condition, a low immunosuppressive status, and the presence of natural killer (NK) or CD8⁺ T cell–activating cytokine were unique features in aqueous humor with Behçet uveitis, suggesting that different immunopathogenic mechanisms may be involved in the ongoing intraocular inflammation of Behçet uveitis.