engleski

Therapeutic effect of the amniotic membrane in herpetic keratitis is mediated by interleukin-1 receptor antagonist

Introduction. Amniotic membrane transplantation (AMT) promotes rapid epithelialization and reduces stromal inflammation and ulceration in HSV-1 keratitis. In this study we have measured production of inflammatory mediators in corneas of patients with herpetic keratitis, together with anti-inflammatory cytokine secreted by AM. Methods. 18 patients with non-healing epithelial defect caused by herpetic keratitis were included in the study. All patients were treated by AMT. At the time of surgery, corneal cells surrounding epithelial defect were collected and their number was counted under microscope. Cells were cultivated for 24h and production of IL-1 and IL-1 in cells supernatant was measured by immunoassay (R&D Systems, USA). Peace of AM from the same donor as AM used in surgery was also cultivated for 24 hours ; interleukin-1 receptor antagonist (IL-1ra) level in its supernatant was measured by immunoassay. Results. Corneal epithelial cells in patients suffering from herpetic keratitis secreted 5 &plusmn ; ; 4, 8 pg/ml of IL-1 and 0, 16 &plusmn ; ; 0, 47 pg/ml of IL-1 (mean &plusmn ; ; SD). Regression of corneal inflammation and closure of epithelial defects were observed clinically in 88 % of patients after amniotic membrane-transplantation. Vision improved in all but two patients. No serious side effects occurred during the follow up. Amniotic membrane that was used to treat investigated patients contained 339, 87 pg/ml of IL-1ra. Conclusion. In herpetic keratitis pro-inflammatory cytokines IL-1 and IL-1 are secreted from corneal epithelial cells. Beneficial effect of the AMT in such patients could be explained by the fact that AM secretes the natural antagonist of these cytokines - IL-ra.

herpetic keratitis; amniotic membrane transplantation; IL 1 ra

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