Uveitis Clinical Trial
Official title:
Clinical Study on the Regulatory T Cells in the Uveitis Patients Treated by Methotrexate
AIM: To study the expression of CD4+CD25+ high regulatory T cells in peripheral blood of patients with uveitis and to explore its role in the development of uveitis.
Uveitis describes inflammation that exists in the uveal tract, but the disease course has
such a variety of manifestations. Uveitis (intraocular inflammatory diseases) includes
sight-threatening diseases such as Behcet disease, birdshot retinochoroidopathy,
Vogt-Koyanagi-Harada, sympathetic ophthalmia and ocular sarcoidosis, and may be of
infectious or autoimmune etiology.
CD4+ CD25+ Tr cells play a key role in the maintenance of peripheral self-tolerance by
inhibiting the activation and proliferation of unreactive T cells. In addition to a direct
suppressor effect on CD4+CD25+ Tr cells. CD4+CD25+ Tr cells may regulate the immune response
through dendritic cell. Like cytotoxic T-lymphocytes and natural killer cells,activated
human CD4+CD25+ Tr cells display perforin-dependent cytoxicity against autologous target
cell, including activated CD4+ and CD8+ T cells.
Experimental autoimmune uveoretinitis (EAU) is a model of uveitis. Regulatory T cells in the
uveitis are currently thought to be the etiologic agent of uveitis because
IFN-γ,IL-2(interleukin-2),TNF(Tumor Necrosis Factor alpha) levels are elevated in the retina
during uveitis Following stimulation with IL-2 expression was upregulated in PBMC(peripheral
blood mononuclear cell) of healthy subjects and patients with scleritis or uveitis. By
ELISA, we confirmed that IL-2 induced the secretion of the protein in human PBMC and in
mouse CD4+T cells. Experiment found, by an intracellular cytokine analysis assay, that the
IFN-γ,IL-2,TNF expressing cells were predominantly CD4+T cells with a memory phenotype.
Consistent with our RNA data, the percentage of CD4+T cells was higher in scleritis patients
than in healthy subjects.
We analyzed peripheral blood of thirty uveitis patients enrolled in Department of
Ophthalmology, Xijing Hospital clinical trials. The demographics of the patients, including
age, sex, diagnosis and medications at time of sample collection .
Biospecimen Description:
Experimental: A Drug: prednisone profess to convinced 1-1.5mg/Kg.d Experimental: B Drug:
methotrexate profess to convinced 7.5-15mg/w, concoction prednisone profess to convinced
0.5-1mg/Kg.d Methods CD4+CD25+ Tr cells, CTLA-4 and an intracellular cytokine analysis assay
that the IFN-γ,IL-2,TNF expressing cells were measured in 30 uveitis patients before and
after 1 month,3 months of prednisone and methotrexate.
Cytokine assays. For intracellular cytokine detect, CD4+T cells were cultured as indicated
above and restimulated for 5h with 1mg/ml phorbol 12-myristate 13-acetate (PMA) and
ionomycin (1mg/ml) in the presence of Golgistop, we added antibodies (IFN-γ,IL-2,TNF). We
performed cytokine staining using BD Biosciences and analyzed samples by flow cytometry.
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Observational Model: Family-Based, Time Perspective: Prospective
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