Diagnosis and prediction ofprimary open-angle glaucoma by the level of local cytokine

Abstract

The incidence of glaucoma is rather high in different countries, being the leading cause of visual loss in the population, thus presuming relevance of the search for new and informative methods of diagnosing this disease. According to modern views, changes of local interleukins seem to be important for the glaucoma pathogenesisis. The aim of present study was to improve diagnosis and prognosis of primary open-angle glaucoma on the basis of information content of interleukins at the local level. The study was conducted on the basis of S. Fyodorov Intersectoral Research and Technology Complex “Eye Microsurgery”. The main group of patients consisted of 109 patients with primary open-angle stage II glaucoma. The age of glaucoma patients ranged from 58 to 75 years with a median of 62.4±2.5 years. The control group consisted of 52 persons without glaucoma at present and in past, the average age of which did not differ significantly from the members of the main group, i.e., 59.6±2.8 years (p > 0.05). The studies of interleukin content in lacrimal fluid was carried out by means of the Multiscan enzyme immunoassay (Finland) using common sandwich-variant of solid-phase enzyme immunoassay with R&D Diagnostic Inc. test systems (USA). The diagnostic significance (informativeness) for local interleukins was calculated according to the generally accepted formula. Statistically significant changes in the levels of lacrimal interleukins were revealed in the patients with primary open-angle glaucoma. The highest increase in the content of local interleukins was found for IL-2 (8.4-fold) and IL-17 (8.3-fold). The content of IL-8 was also increased significantly in the lacrimal fluid of patients with primary open-angle glaucoma. However, the changes in the studied local anti-inflammatory interleukins proved to be multidirectional: the level of IL-4 in the formed primary open-angle glaucoma was significantly increased, and the level of IL-10, on the contrary, was decreased. Evaluation of diagnostic significance by the local interleukin levels showed the maximal informative value for IL-2 (J = 637.4), and IL-17 (J = 612.8), which indicates their leading role for diagnostics of primary open-angle glaucoma. High level of information content is typical for IL-8 (J = 572.5). Using regression analysis for the most informative interleukins in lacrimal fluid, we have developed a mathematical model that provides a high-probability prediction (P < 0.001) of primary open-angle glaucoma. Lacrimal concentrations of IL-2, IL-7 and IL-8 are the most informative indexes of lacrimal fluid for the diagnosis and prediction of primary open-angle glaucoma.

Keywords

• glaucoma
• interleukins
• laboratory diagnostics
• forecasting
• morbidity