Povišena koncentracija faktora nekroze tumora alfa u plazmi bolesnika sa glaukomоm
Sažetak
Uvod/Cilj. Promene u koncentraciji različitih medijatora zapaljenja u krvi, očnoj vodici ili tkivima oka, podržavaju teoriju o ulozi inflamacije u patogenezi glaukoma otvorenog ugla (GOU). Biomarkeri inflamacije imaju veliki potencijal za primenu u kliničkoj praksi. Cilj rada bio je da se utvrde koncentracije faktora nekroze tumora alfa (tumor necrosis factor alpha – TNF-α) u plazmi bolesnika sa GOU i ispitanika bez glaukoma, i prouči veza između nivoa TNF-α u plazmi bolesnika sa glaukomom i određenih kliničkih parametara. Metode. Studijom je obuhvaćeno 87 učesnika (87 očiju) podeljenih u tri grupe: 35 ispitanika (35 očiju) obolelih od primarnog GOU (PGOU), sa povišenim
intraokularnim pritiskom (IOP) – hipertenzivni glaukom (HTG) (PGOU-HTG), 23 ispitanika (23 oka) koji boluju od pseudoeksfolijativnog GOU (PEG) i 29 ispitanika u kontrolnoj grupi (zdravi ispitanici), sparenih po starosti i polu, sa obolelima od GOU. Urađen je kompletan oftalmološki pregled, standardna automatizovana perimetrija i određivanje promena u ponovljenom vidnom polju ispitanika, optička koherentna tomografija i određivanje debljine retinalnih peripapilarnih nervnih vlakna (retinal nerve fiber layer – RNFL). Koncentracija TNF-α u plazmi ispitanika merena je komercijalnim enzyme-linked immunosorbent assay-ELISA testovima. Rezultati. Koncentracije TNF-α u plazmi bolesnika sa glaukomom (PGOU-HTG 2,04 ± 1,98 pg/mL i PEG 2,05 ± 1,48 pg/mL) bile su značajno više nego kod zdravih ispitanika (1,43 ± 2,00 pg/mL, p < 0,05). Ni u jednoj od grupa ispitanika obolelih od glaukoma nije bilo statistički značajne korelacije koncentracije TNF-α u plazmi sa bilo kojim od ispitanih kliničkih parametara [IOP, cup/disk ratio, srednja vrednost devijacije (mean deviation), prosek RNFL (RNFL average), RNFL superiorni kvadrant i RNFL inferiorni kvadrant]. Zaključak. Koncentracija pro-inflamacijskog citokina TNF-α u plazmi je značajno viša kod bolesnika sa glaukomom u poređenju sa ispitanicima bez glaukoma i to potvrđuje ulogu inflamacije u patogenezi glaukoma, kao jednog od neinflamacijskih oboljenja oka. Koncentracija TNF-α u plazmi bolesnika sa glaukomom ne koreliše ni sa jednim od ispitivanih kliničkih parametara, zbog čega ne može biti mera progresije i oštećenja kod glaukoma.
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