The Value of the Antibody Detection in the Diagnosis of Ocular Toxocariasis and the Aqueous Cytokine Profile Associated With the Condition.
The Value of the Antibody Detection in the Diagnosis of Ocular Toxocariasis and the Aqueous Cytokine Profile Associated With the Condition.
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抗体检测在眼弓蛔虫病诊断中的价值以及与该病症相关的水性细胞因子谱
DOI：
10.3389/fmed.2022.838800
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发表时间：
2022
影响因子：
3.9
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中科院分区：
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评估和比较犬弓蛔虫特异性抗体在血清和房水样本中检测对眼弓蛔虫病（OT）诊断的特异性，并探索儿童眼弓蛔虫病相关的细胞因子图谱。
这是一项前瞻性队列研究。纳入标准为眼弓蛔虫病的临床表现，包括单侧视力下降、伴有不同程度玻璃体炎的典型周边或后极部肉芽肿，并排除其他诊断。测量从患眼获取的血清和房水样本中针对犬弓蛔虫排泄 - 分泌抗原的抗体滴度[T - 免疫球蛋白G（IgG）]。当血清或房水中T - IgG检测为阳性时，即可诊断为眼弓蛔虫病。其余具有上述典型临床表现但血清或房水T - IgG无法确认为阳性的患者被诊断为疑似眼弓蛔虫病。使用多重流式细胞术微球阵列系统测量细胞因子。
211名患者的211只眼参与了该研究。128只眼被诊断为眼弓蛔虫病。该队列的中位年龄为7.7岁，男女比例为2.5 : 1。主要的初始症状是视力下降（74%）和斜视（22%）。伴有周边肉芽肿、后极部肉芽肿和眼内炎的眼所占百分比分别为40%、18%和41%。玻璃体炎（100%）、玻璃体条索（64%）、视网膜纤维带（57%）和视网膜脱离（42%）是最常见的体征。房水样本中T - IgG阳性率为66.7%，血清样本中为57.2%。44名患者患眼的血清和房水中T - IgG均为阴性。白细胞介素（IL）- 6、单核细胞趋化蛋白（MCP）- 1、IL - 8、嗜酸性粒细胞趋化蛋白（Eotaxin）、MCP - 1β和血管内皮生长因子（VEGF）在T - IgG阴性眼中比对照组高，在T - IgG阳性眼中进一步升高。然而，只有T - IgG阳性眼显示IL - 5、IL - 13和IL - 10升高。所有眼中均未检测到IL - 1β、肿瘤坏死因子 - α（TNF - α）、IL - 12、IL - 2、干扰素 - γ（IFN - γ）和IL - 4。
儿童眼弓蛔虫病常伴有严重的视网膜并发症。仅在房水T - IgG阳性眼中发现极化的眼内Th2反应。我们的研究结果支持基于房水样本的抗体检测对眼弓蛔虫病进行更特异的诊断。
To evaluate and compare the specificity of Toxocara canis-specific antibody detection in the serum and aqueous samples for the diagnosis of ocular toxocariasis (OT) and explore the cytokine profiles associated with the condition in children. This is a prospective cohort study. The inclusion criteria were the clinical presentations of OT, which included unilateral vision reduction, typical peripheral or posterior pole granuloma with variable degrees of vitritis, and exclusion of other diagnoses. The titer of antibody against the excretory-secretory antigen of Toxocara canis [T-immunoglobulin G (IgG)] was measured in serum and aqueous samples that were taken from the affected eyes. The diagnosis of OT was made upon positive detection of T-IgG either in the serum or aqueous. The rest with typical clinical presentations as described above but a positive serum or aqueous T-IgG could not be confirmed were diagnosed as suspected OT. Cytokines were measured using multiplexed cytometric bead array system. Two hundred and eleven eyes of 211 patients had participated in the study. One hundred and twenty-eight eyes were diagnosed as OT. The median age of the cohort was 7.7 years with a male to female ratio of 2.5:1. Major initial symptoms were decreased vision (74%) and strabismus (22%). The percentages of eyes with peripheral granuloma, posterior granuloma, and endophthalmitis were 40, 18, and 41%, respectively. Vitritis (100%), vitreous strands (64%), retinal fibrotic bands (57%), and retinal detachment (42%) were the most common signs. T-IgG was positive in 66.7% of the aqueous and 57.2% of the serum samples. Forty-four patients were diagnosed T-IgG negative in both serum and aqueous of the affected eyes. Interleukin (IL)-6, monocyte chemoattractant protein (MCP)-1, IL-8, eosinophil chemotactic protein (Eotaxin), MCP-1β, and vascular endothelial growth factor (VEGF) were higher in T-IgG negative eyes when compared to controls and further increased in T-IgG positive eyes. However, only T-IgG positive eyes showed increased IL-5, IL-13, and IL-10. IL-1β, tumor necrosis factor-alpha (TNF-α), IL-12, IL-2, interferon-gamma (IFN-γ), and IL-4 were undetectable in all eyes. Pediatric OT is often present with severe retinal complications. Polarized intraocular Th2 response was only found in aqueous T-IgG positive eyes. Our results supported an aqueous sample-based antibody test for the more specific diagnosis of OT.