CLINICAL SCIENCE

Systemic inflammation and innate immune response in patients with previous anterior uveitis

M Huhtinen¹, H Repo², K Laasila³, S-E Jansson⁴, H Kautiainen⁵, A Karma¹ and M Leirisalo-Repo³

¹ Department of Ophthalmology, University of Helsinki, Helsinki, Finland
² Division of Infectious Diseases and Department of Bacteriology and Immunology
³ Division of Rheumatology
⁴ Department of Clinical Chemistry
⁵ The Rheumatism Foundation Hospital, Heinola, Finland

Correspondence to:
Correspondence to:
Minna Huhtinen, MD, Helsinki University Eye Hospital, PO Box 220, FIN-00029 HUS, Finland;
minna.huhtinen{at}hus.fi

Aim: To determine the presence of systemic inflammation and innate immune responsiveness of patients with a history of acute anterior uveitis but no signs of ocular inflammation at the time of recruitment.

Methods: Tumour necrosis factor (TNF-) production in response to bacterial lipopolysaccharide (LPS) was studied using whole blood culture assay; levels of TNF- in culture supernatants, and soluble interleukin 2 receptor (sIL-2R) in serum were determined by chemiluminescent immunoassay (Immulite); monocyte surface expression of CD11b, CD14, and CD16 and the proportion of monocyte subsets CD14^brightCD16^- and CD14^dimCD16⁺ were studied with three colour whole blood flow cytometry; and serum C reactive protein (CRP) levels were determined using immunonephelometric high sensitivity CRP assay.

Results: The CRP level (median, interquartile range) was significantly higher in 56 patients with previous uveitis than in 37 controls (1.59 (0.63 to 3.47) µg/ml v 0.81 (0.32 to 2.09) µg/ml; p=0.008). The TNF- concentration of the culture media per 10⁵ monocytes was significantly higher in the patient group than in the control group in the presence of LPS 10 ng/ml (1473 (1193 to 2024) pg/ml v 1320 (935 to 1555) pg/ml; p=0.012) and LPS 1000 ng/ml (3280 (2709 to 4418) pg/ml v 2910 (2313 to 3358) pg/ml; p=0.011). The background TNF- release into the culture media was low in both groups. CD14 expression of CD14^brightCD16^- monocytes, defined as antibody binding capacity (ABC), was similar for the patients and controls (22 839 (21 038 to 26 020) ABC v 21 657 (19 854 to 25 646) ABC).

Conclusions: Patients with previous acute anterior uveitis show high innate immune responsiveness that may play a part in the development of ocular inflammation.

Keywords: inflammation; immunity; anterior uveitis

Abbreviations: AAU, acute anterior uveitis; ABC, antibody binding capacity; CRP, C reactive protein; EIA, endotoxin induced uveitis; EIU; endotoxin induced uveitis; LPS, lipopolysaccharide; sIL-2R, soluble interleukin 2 receptor; SpA, spondyloarthropathy; TNF-, tumour necrosis factor

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