Serum Cytokine Profiles Associated with Intraocular Inflammation after Cataract Surgery in Children with Juvenile Idiopathic Arthritis

Abstract

Objective: To investigate the role of Th17, Th1 and regulatory T cell (Treg)-related pro-inflammatory cytokines on postoperative inflammation in children with juvenile idiopathic arthritis (JIA). Methods: This was a retrospective case-control study. Serum from 32 children with JIA and 35 controls with congenital cataract in Inner Mongolia Autonomous Region People's Hospital from July 2013 to March 2018 were ennolled before surgery and 1, 7, 30 and 90 days after surgery, and aqueous humor (AqH) was collected at the commencement of surgery. Protein levels of inter leukin-1 beta (IL-1β), IL-6, IL-10, IL-23, IL-27, IL-17 and IFN-gamma in serum and AqH were determined by the multiplexed immunoassay method. A laser flare-cell photometer was used to quantify intraocular inflammation. Repeated measurements of variance was used for statistical analysis of data. A Spearman correlation coefficient test was used to evaluate the correlation between the protein levels of IL-6, IL-23, IFN-gamma in serum and AqHand intraocular inflammation in JIA patients. Results: Serum IL-1β (106±27 pg/ml), IL-6 (305±82 pg/ml), IL-10 (202±114 pg/ml), IL-23 (612±190 pg/ml), IL-27 (110±43 pg/ml) and IFN-gamma (172±43 pg/ml) levels were significantly higher in children with JIA when compared to control patients after the first day postoperatively, decreased rapidly, and attenuated gradually. AqH levels of the cytokines were below the detection level in children with JIA and controls. Notably, the following serum levels were strongly correlated with aqueous flare values in children with JIA: Serum IL-6 levels (r=0.085, P=0.002), serum IFN-gamma levels (r=0.741, P=0.021), serum IL-23 levels (r=0.622, P=0.028). Serum IL-6 levels (r=0.729, P=0.006), and serum IFN-gamma levels (r=0.669, P=0.019) correlated with aqueous cells. Serum IL-23 levels were not correlated with AqH in children with JIA (r=0.646, P=0.051). Conclusion: The increase in the number of Th17, Th1 and regulatory T cell related proinflammatory cytokines IL-6 and IFN-gamma can reflect inflammation in JIA children's eyes after surgery. Serum IL-1beta, IL-10, IL-23 and IL-27 levels can be used to evaluate postoperative intraocular inflammation. Key words: juvenile idiopathic arthritis; uveitis; inflammatory; cytokine; multiplexed bead flow cytometry; cataract; surgery