Differential cytokine responses from intraocular T-cells between ocular TB and indeterminate uveitis, in uveitis patients with positive tuberculin skin test
Purpose
To compare intraocular T-cell cytokine responses between ocular tuberculosis (OTB) and indeterminate (IND) cases in patients with positive tuberculin skin test (TST)
Methods
TST-positive patients with vitritis >=grade 2, were classified into OTB (positive polymerase chain reaction [PCR] and/or active systemic TB) or IND (PCR-negative, no systemic TB). TST-negative non-TB uveitis cases were controls. Vitreous samples were collected, and T-cells isolated as previously described. CD4+/CD8+ selection was not done due to low cell counts. Cells were activated with 10mcg/mL of TB-specific ESAT-6 peptide (BEI Resources), fixed and stained with specific antibodies as per manufacturer’s protocol. Stained cells were acquired by CytoFLEX S (Beckman Coulter) flow cytometer and analysed with CytExpert Software.
Results
Fourteen patients (OTB=5, IND=5, controls=4) were included. IFNg and TNFa mono-functional responses to ESAT-6 activation, were significantly higher in IND cases as compared to OTB (p=0.004 and 0.023 respectively) and controls (p=0.002 and 0.006 respectively). The IFNg-TNFa dual positive response was also significantly higher in the IND group as compared to OTB (p=0.001) and controls (p=0.006).
Conclusion
The pro-inflammatory cytokine response in intraocular T-cells to TB-specific antigen is significantly higher in the IND group as compared to OTB. This difference probably reflects a stronger, more effective host immune response and therefore lower bacillary load in indeterminate TST-positive cases, as compared to the OTB group with higher bacillary load.
Conflict of interest
No
Authors 1
Last name
BASU
Initials of first name(s)
S
Department
L V Prasad Eye Institute
City
Hyderabad
Country
India
Authors 2
Last name
SHARMA
Initials of first name(s)
G
Department
L V Prasad Eye Institute
City
Hyderabad
Country
India
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