Could different aqueous humor and plasma cytokine profiles help differentiate between ocular sarcoidosis and ocular tuberculosis?

Objective and design A cross-sectional single-center study was conducted to assess cytokine levels in aqueous humor (AH) and plasma of three different uveitis entities: definite ocular sarcoidosis (OS), definite OS associated with QuantiFERON (R)-TB Gold test positivity (Q + OS) and presumed tubercular uveitis (TBU). Subjects Thirty-two patients (15 OS, 5 Q + OS, 12 TBU) were included. Methods Quantification of selected cytokines was performed on blood and AH samples collected before starting any treatment. Statistical analysis was conducted using the Kruskal-Wallis test, the Mann-Whitney or Fisher test and the Principal Component Analysis (PCA). Results IL-6, IL-8 and IP-10 levels were higher in AH samples than in peripheral blood. In AH samples, BLC, IL-8 and IP-10 were significantly higher in definite OS than in presumptive TBU. There were no statistically significant differences in terms of cytokine levels between Q + OS and presumptive TBU. PCA showed a similar cytokine pattern in the latter two groups (IFN gamma, IL-15, IL-2, IP-10, MIG), while the prevalent expression of BLC, IL-10 and MIP-3 alpha was seen in definite OS. Conclusions The different AH and plasma cytokine profiles observed in OS compared to Q + OS and TBU may help to differentiate OS from TBU in overlapping clinical phenotypes of granulomatous uveitis (Q + OS).

Automated summary

This study evaluated cytokine levels in different types of uveitis and found differences in cytokine profiles in definite ocular sarcoidosis (OS), definite OS associated with QuantiFERON (R)-TB Gold test positivity (Q + OS), and presumed tubercular uveitis (TBU), which may aid in distinguishing these entities from each other.