Cytokine profiles of macular neovascularization in the elderly based on a classification from a pachychoroid/drusen perspective
Cytokine profiles of macular neovascularization in the elderly based on a classification from a pachychoroid/drusen perspective
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DOI：
10.1007/s00417-021-05445-0
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发表时间：
2021-10-29
影响因子：
2.7
通讯作者：
Kawashima, Hidetoshi
中科院分区：
文献类型：
--
作者：
Inoda, Satoru;Takahashi, Hidenori;Kawashima, Hidetoshi
目的根据厚脉络膜和玻璃体特征对黄斑新生血管(macular neovasculation，MNV)进行分类，并检测各组的房水细胞因子特征。15种细胞因子的房水浓度在根据玻璃体和/或厚脉络膜特征分类的MNV组中进行了比较。结果31只眼分为厚脉络膜相关组、18只眼、43只眼和10只眼，其中厚脉络膜相关组31只眼，玻璃体相关组43只眼，厚脉络膜/玻璃体相关组10只眼，非玻璃体/非厚脉络膜组10只眼。与对照组相比，各MNV组细胞因子均有不同程度的上调。C反应蛋白和CXCL12在所有MNV组均显著上调，而CXCL13和IL-8在除非厚脉络膜/非玻璃体相关性MNV组外的三组均显著上调。除软骨膜相关MNV组外，Ang-2在MNV组、MNV组和MNV组均显著上调。在厚脉络膜相关和玻璃体相关的MNV组中，PlGF显著上调。CCL-2在厚脉络膜相关性MNV组和厚脉络膜/玻璃体相关MNV组显著上调。在厚脉络膜相关和玻璃体相关的MNV组中，血管内皮生长因子的表达分别下调。多维标度分析显示各MNV组具有不同的细胞因子谱。“新生血管性老年性黄斑变性伴玻璃体及伴发厚脉络膜”与“厚脉络膜新生血管病”和“脉络膜新生血管伴玻璃体”的病因学相似，但与无此病因者的病因学不同。这些发现提示在诊断新生血管性老年性黄斑变性时评估玻璃体和脉络膜的重要性。
Purpose To classify macular neovascularization (MNV) based on pachychoroid and drusen features and to examine the aqueous humor cytokine signatures of each group.Methods In total, 106 consecutive eyes with treatment-naive MNV and 104 control eyes were examined. The aqueous humor concentrations of 15 cytokines were compared among the MNV groups classified based on the presence of drusen and/or pachychoroid features. Multidimensional scaling analysis was used to visualize the similarity level of the MNV subtypes according to their cytokine profiles.Results Thirty-one, 18, 43, and 10 eyes were classified into the pachychoroid-associated, drusen-associated, pachychoroid/drusen-associated, and non-drusen/non-pachychoroid MNV groups, respectively. Compared with the control group, cytokines were differently upregulated among the MNV groups. CRP and CXCL12 were significantly upregulated in all MNV groups, whereas CXCL13 and IL-8 were significantly upregulated in three MNV groups, excluding the non-pachychoroid/non-drusen-associated MNV group. Ang-2 was significantly upregulated in three MNV groups except the drusen-associated MNV group. PlGF was significantly upregulated in the pachychoroid-associated and drusen-associated MNV groups. CCL-2 was significantly upregulated in the pachychoroid-associated and pachychoroid/drusen-associated MNV groups. VEGF was downregulated in the pachychoroid-associated and drusen-associated MNV groups, respectively. Multidimensional scaling analysis showed a distinct cytokine profile for each MNV group.Conclusion All MNV groups showed distinct cytokine profiles. Eyes with "neovascular age-related macular degeneration with drusen and concomitant pachychoroid" may share a similar etiology to those with "pachychoroid neovasculopathy" and "choroidal neovascularization with drusen," but have a distinct etiology to those without these. These findings suggest the importance of evaluating drusen and the choroid during the diagnosis of neovascular age-related macular degeneration.