Observation on the Treg in the Uveitis Patients
Condition: Uveitis
MeSH terms: Uveitis
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Observational model: Family-Based
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Ages eligible for Study:18 Years to 60 Years. Study Population had two eye attacks in a
        year.
      
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
    
Keywords: CD4/CD25 Tr cell,TNF,IFN-γ,IL-2