Dysregulated Chronicity in Inflammation With Clinical Phenotype of Presumed Tubercular Uveitis Is Decided by Activated IL-17+ T Cells and Inflammatory Cytokines
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Yes
Purpose
To study T cell subsets in TBU patients and their possible associations. IL17A upon activation in the TBU cohort and FoxP3+ in the TBU and Non-infectious Uveitis cohort (NIU) were the critical subsets.
Methods
Patients with positive Mantoux, QuantiFERON TB Gold Test, High-Resolution Computed Tomography of the chest, and PCR from ocular fluids were included. 17 TBU patients, 18 NIU patients, and age-matched healthy controls were included. On freshly collected peripheral blood samples flow cytometry analysis was performed.
Results
CD4 T cells gated for IL17 show a marginal expression increase in TBU patients and those with NIU. However, after stimulation in culture, CD4 T cells show a marked increase in IL17 (p=0.001), producing copious IL17, known to be associated with TB uveitis. In both ocular TB and NIU patients, T regs showed an increase compared to the healthy group without ocular complications. Likewise, the frequency of the CD4+ CD45RO+ T cells identified as memory T cells and CD4+ CD25+ FoxP3+ and CD45RO+ had greater counts and were statistically significant in both the TBU as well as NIU cohort (p=0.04) compared to healthy controls. The inflammatory phenotype in presumed TBU shows increased percentages of IL17+ T helper cells with greater response to activation in the TBU cohort.
Conclusion
Contribution to inflammatory activity is of greater importance compared to T regulatory cell percentages. Activated Th17 cells and their inflammatory phenotype may be potential drivers contributing to chronic inflammation. This may be further exacerbated as CD45RO T cell levels increase suggesting hypersensitivity.
Conflict of interest
No
1
Last name
BISWAS
Initials of first name(s)
J
Department
Director of Uveitis & Ocular Pathology Department, Sankara Nethralaya,
City
Chennai
Country
India
2
Last name
Lavanya
Initials of first name(s)
E
Department
Department of Ocular Pathology & Biotechnology
City
Chennai
Country
India
3
Last name
Sudharshan
Initials of first name(s)
S
Department
Department of Uvea
City
Chennai
Country
India
4
Last name
Chatterjee
Initials of first name(s)
N
Department
Department of Ocular Pathology
City
Chennai
Country
India
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