The role of autoimmune mechanisms in pathogenesis of primary open-angle glaucoma
PURPOSE: To evaluate the role of cytokines IL-17, IL-6, TGF-B1 and TGF-B3 in the immune response in patients with primary open-angle glaucoma (POAG). METHODS: Using specific ELISA test systems «R&D Diagnostics Inc.» (USA), we investigated blood serum and tear fluid of 110 subjects (80 POAG patients and 30 healthy subjects). Mean age was 57.0±3.2 years (78 years in women and 37 - in men). From 42 patients diagnosed with glaucoma, 38 had advanced and terminal stages. Patients were subdivided into 2 subgroups: with POAG only and POAG combined with chronic pathology (hypertensive disease, type 2 diabetes, myopia). RESULTS: All patients demonstrated high levels of IL-17, IL-6 and low levels of TGF-B1 and TGF-B3 in blood serum and lacrimal fluid. The study revealed varied changes in inves- tigated biological fluids. Thus, IL-6 production was higher in the systemic circulation compared to the local, while the production of IL-17, on the contrary, was higher in the lacrimal fluid. Anterior chamber examination also revealed high local hypercytokinemia (IL-6, IL-17). Reduced concentration of the TGF-B cytokine group may be associated either with its utilization during hyperergic inflammatory reactions or with insufficient response. Similar immunological changes were also observed in the combined pathology subgroup (POAG with hypertension, type 2 diabetes, myopia) due to the similarity in the pathogeneses of these diseases: genetic, vascular, neuroendocrine.