CLINICAL RELATIONSHIP BETWEEN CYTOKINE CONCENTRATION IN ATRIAL FLUID AND PRIMARY GLAUCOMA

Hao Niu¹, Yang Yang¹, Na Zhao^{1, *}, Junping Gao², Huiming Li¹, Li Zhang¹ 

¹Gu yuan People’s Hospital, Ning xia, Gu yuyan - ²Health Conmmitte of Gu yuan, Ning xia, Gu yuyan

Objective: Glaucoma is a group of diseases characterized by optic nerve atrophy and visual field defects in common. Atrial fluid is inextricably linked to the development and progression of glaucoma, and the detection of cytokines in atrial fluid is one of the current hot topics in glaucoma research. Researchers hope to find one or several biomarkers in atrial fluid to answer clinical questions such as screening and early diagnosis of glaucoma in high-risk groups. Previously, the main obstacle limiting the detection of cytokines in atrial fluid was the small volume of atrial fluid specimens, while the liquid-phase suspension microarray technology has solved this problem by enabling multi-factor detection in small volume samples. In addition, there are few studies on the correlation between atrial fluid cytokine concentrations and the prognosis of trabeculectomy surgery in glaucoma patients, and it would be helpful to identify factors associated with the prognosis of trabeculectomy surgery for the follow-up management of glaucoma patients after surgery. 

Methods: 1.90 participants were selected to collect atrial fluid specimens(30 patients with POAG, 30 patients with PACG (including 15 patients with APACG and 15 patients with CPACG) and 30 patients with senile cataract).2.IL-6, IL-8, IFN-γ, MCP-1, TNF-α, Cathepsin D, sNCAM and other molecules were detected in the atrial fluid specimens using Luminex liquid-phase suspension microarrays. 3. 60 patients with primary glaucoma underwent trabeculectomy by the same surgeon and were followed up for 24 months after surgery, with IOP as the main index, and the correlation between cytokine concentrations in atrial fluid and the prognosis of trabeculectomy was analyzed using the Kaplan-Meier method and Cox proportional risk regression model.

Results: 1. Cathepsin D and sNCAM (P<0.001) concentrations in the atrial fluid of patients in the POAG group were significantly higher than those in the senile cataract group; IFN-γ (P=0.02) concentrations were significantly lower than those in the senile cataract group.2.Cathepsin D, sNCAM, IL-6, IL-8 and MCP-1 (P<0.001) and TNF-α (P=0.001) concentrations in atrial fluid were significantly higher in the PACG group than in the senile cataract group.3.The concentrations of sNCAM, IL-6, IL-8, MCP-1 (P<0.001) and TNF-α (P=0.007) in the atrial fluid were significantly higher in the PACG group than in the POAG group.4.The concentration of IL-6 (P=0.02) in the atrial fluid of patients in the APACG group was significantly higher than that in the CPACG group.5. Cathepsin D (ρ=-0.67, P<0.001), IL-6 (ρ=-0.78, P<0.001), IL-8 (ρ=-0.62, P=0.001), MCP-1 (ρ=-0.69, P<0.001) and TNF-α (ρ=-0.69, P<0.001) in the atrial fluid of patients with POAG were significantly correlated with MD values.6. The follow-up study suggested that the number of previous anti-glaucoma drug types was a risk factor for trabeculectomy (RR=14.01, P=0.02), while atrial cytokine concentrations did not correlate with trabeculectomy.

Conclusion: 1.Liquid-phase suspension microarray technology is a good way to quantify cytokine concentrations in atrial water. 2.Altered cytokine concentrations in atrial water in patients with POAG may reflect damage to the trabecular meshwork and optic nerve. 3.Altered atrial cytokine concentrations in PACG patients may be associated with blood-atrial water barrier disruption, intraocular ischemia and hypoxia, and ischemia-reperfusion injury. 4.The number of types of antiglaucoma drugs used previously is a risk factor for trabeculectomy surgery.