Journal Article

Morphological and cytokine profiles as key parameters to distinguish between Gram-negative and Gram-positive bacterial keratitis

Elabiary, Mariam, Cendra Gascón, María del Mar, Universitat Politècnica de Catalunya. Departament d'Enginyeria Agroalimentària i Biotecnologia, Christodoulides, Myron, Konstantopoulos, Aris, Hossain, Parwez, Tsatsos, Michael

2020

Overview

Bacterial keratitis (BK) is an ocular disorder associated with poor visual prognosis. Quantification of the associated inflammatory response may provide insight into the pathogenesis of BK and guide treatment options. In this exploratory study, we evaluated 45 BK patients and 20 healthy controls by optical coherence tomography and pro-inflammatory tear cytokine analysis. The aim was to quantify the differential morphological and cytokine inflammatory response between Gram-negative and Gram-positive BK and to determine the diagnostic value of corneal thickness (CT) and infiltrate thickness (IT) in distinguishing Gram−ve BK in a clinical cohort. Greater CT and IT, at clinical presentation, were indicative of Gram−ve infection with values detected of ≥ 950 μm and ≥ 450 μm, respectively. Combination of these CT and IT values had a 100% sensitivity and 83.3% specificity as a diagnostic indicator of Gram−ve infection. Similarly, there were higher levels of IL-1β, IL-6 and IL-8 cytokines were quantified in keratitis caused by Gram-negative bacteria. Among the different tear cytokines analysed, a significant reduction after three days of treatment was detected for pro-inflammatory cytokines IL-1β, IL-2, IL-6, IL-8 and TNF-α, prior to starting with the administration of steroid drops. Overall, this study shows the potential value of serial OCT and tear cytokine measurements in the management of BK.

• Publisher: Nature,Nature Publishing Group UK,Nature Publishing Group
• Subject: 631/250/127 / 631/326 / 692/308 / Bacteria / Cornea / Cytokines / Cytokines - analysis / Diagnosis, Differential / Eye Infections, Bacterial - diagnosis / Eye Infections, Bacterial - metabolism / Eye Infections, Bacterial - microbiology / Female / Gram-negative bacteria / Gram-Negative Bacteria - isolation & purification / Gram-Negative Bacterial Infections - diagnosis / Gram-Negative Bacterial Infections - metabolism / Gram-Negative Bacterial Infections - microbiology / Gram-Positive Bacteria - isolation & purification / Gram-Positive Bacterial Infections - diagnosis / Gram-Positive Bacterial Infections - metabolism / Gram-Positive Bacterial Infections - microbiology / Humanities and Social Sciences / Humans / IL-1β / Inflammation / Interleukin 2 / Interleukin 6 / Interleukin 8 / Keratitis / Keratitis - diagnosis / Keratitis - metabolism / Keratitis - microbiology / Male / Middle Aged / Morphology / multidisciplinary / Science / Science (multidisciplinary) / Tears - chemistry / Tomography, Optical Coherence / Tumor necrosis factor-α