Tear Fluid Inflammatory Factor Profile in Patients with HLA-B27-Associated Uveitis.
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PURPOSE: To evaluate the levels of inflammatory factors in tear fluid of patients with Human Leukocyte Antigen (HLA)-B27-associated uveitis, elucidating the underlying immunopathogenic mechanisms and identifying potential biomarkers for therapeutic targeting. METHODS: Eighteen patients with unilateral HLA-B27-associated uveitis and 23 healthy controls were included in the study. Schirmer's strips-based tear fluid was used to measure the levels of Interleukin (IL)-1β, IL-6, IL-17A, IL-10, Tumour Necrosis Factor alpha (TNFα), Matrix Metalloproteinase 9 (MMP9), Intercellular Adhesion Molecule 1 (ICAM1) and Vascular Endothelial Growth Factor-A (VEGF-A) by microfluidic cartridge‑based multiplex ELISA. RESULTS: Tear fluid levels of IL-17A and MMP9 were significantly elevated in eyes with active uveitis compared to controls (p < 0.01). Additionally, IL-17A level was significantly higher in eyes with multiple uveitis episodes compared to controls (p < 0.05). Distinct inter-cytokine correlations were observed between uveitic and control eyes. Positive correlations observed between IL-17A and MMP9; and MMP9 and TNFα were limited to uveitic eyes. Similarly, positive correlations of ICAM-1 levels with IL-1β, IL-6, IL-17A, TNFα and MMP9 were observed only in eyes with uveitis and not in control eyes. CONCLUSION: Elevated levels of IL-17A and MMP9 in patients suggests their central role in mediating inflammatory process and highlights their potential as novel therapeutic targets in the management of HLA-B27-associated uveitis.