Correlation Between Cytokine IL-1β,IL-6,IL-8,IL-10,TNF-α,and IL-12p70 Concentrations In Atrial Fluid And Diabetic Macular Edema

Objective:To study the concentration of interleukin-1β(IL-1β),IL-6,IL-8,IL-10,IL-12p70 and tumor necrosis factor alpha(TNF-α)in atrial fluid in relation to intravitreal injection of ranibizumab(IVR)for diabetic macular edema(DME).Method:Forty patients(40 eyes)with diabetic macular edema initially diagnosed in our ophthalmology department from December 2019 to December 2021 were selected as the treatment group(one eye was randomly included if both eyes met the inclusion criteria),all patients received IVR once a month for 3 months.Twenty patients(20 eyes)with age-related cataract alone who underwent cataract surgery at the same time were selected as the control group.Atrial fluid was collected from the treatment group before and 2 months after surgery and from the control group before surgery,and the concentrations of IL-1β,IL-6,IL-8,IL-10,IL-12p70 and TNF-α in the atrial fluid were measured using the microsphere method.To compare the differences in cytokine concentrations in the atrial water between the treatment and control groups before surgery;to analyze the correlation between cytokine concentrations in the atrial water and central macular thickness(CMT)in the treatment group before surgery;to analyze the correlation between cytokines in the atrial water before surgery;to compare the changes in cytokine concentrations,CMT and best corrected visual acuity(BCVA)in the preoperative and postoperative atrial fluid in the treatment group.Results: All included 40 DME completed 3 consecutive IVR treatments.The concentrations of cytokines IL-1β,IL-6,IL-8,IL-12p70 and TNF-α in the preoperative atrial fluid were higher in the treatment group compared with the control group,and the differences were statistically significant;among them,the concentrations of IL-6 and IL-8 were significantly higher,and both showed positive correlations with CMT(r=0.589,0.590,both P<0.001).Correlation analysis between IL-1β,IL-6,IL-8,IL-10,IL-12p70 and TNF-α cytokines in the preoperative atrial fluid in the treatment group: IL-6 and IL-8were correlated(r=0.654,P<0.001);IL-8 was correlated with IL-1β(r=0.391,P<0.001);IL-12p70 correlated with TNF-α and IL-1β(r=0.534,0.735,P<0.001),and all were statistically significant.Compared with the preoperative atrial fluid cytokine concentrations in the treatment group,the postoperative atrial fluid concentrations of IL-1β,IL-6,IL-8,IL-12p70 and TNF-α decreased significantly,and the differences were statistically significant(z=-4.467,-5.232,-5.518,-4.291,-4.386,all P<0.001),but the cytokine IL-10 postoperative concentrations did not show a significant decrease,and the difference was not statistically significant(z=-2.394,P>0.05).In the treatment group,postoperative CMT and BCVA were compared with preoperative: postoperative CMT decreased significantly compared with preoperative,and postoperative BCVA increased compared with preoperative,and both were statistically significant(z=5.551,5.473,P<0.01).Conclusion: The concentrations of cytokines IL-1β,IL-6,IL-8,IL-12p70 and TNF-α in atrial fluid were correlated with DME,among which IL-6 and IL-8 were positively correlated with the severity of macular edema.The cytokines IL-1β,IL-8,IL-12p70 and TNF-α in preoperative atrial fluid interacted with each other,suggesting a joint involvement in the pathogenesis of macular edema.The vitreous cavity injection of ranibizumab treatment reduced the concentrations of IL-1β,IL-6,IL-8,IL-12p70 and TNF-α in atrial fluid while improving macular edema and visual acuity.