Non-Invasive Test Can Detect Uveitis Biomarkers in Tears

Published November 2021 | Ocular Immunology and Inflammation

Sight-robbing eye damage is one of the most unfortunate outcomes for children diagnosed with juvenile idiopathic arthritis. JIA-associated uveitis (JIA-U) occurs in 10-20% of children with JIA and sight-threatening complications occur in up to 50% of affected children.

While clinicians can look for signs of eye inflammation during ophthalmic exams, experts have been hunting for a reliable biomarker that can more accurately detect early signs of JIA-U.

Previous research has found that certain S100 proteins, cytokines, and chemokines can serve as biomarkers. However, when these tests are conducted using serum the results are not accurate. When collected via aqueous humor (AqH), the results are accurate, but the invasive collection method makes it not feasible unless a child is having eye surgery.

Now, a team of researchers led by Sheila Angeles-Han, MD, MSc, Mekibib Altaye, PhD, and colleagues reports that these biomarkers can be collected from tears using Schirmer strips (small sterile slips of paper often used to measure tear volume).

In children with active uveitis, the biomarkers S100A12, IL-8, and sICAM-1 were all significantly increased compared to children with inactive uveitis.

“S100A12, IL-8, and sICAM-1 are associated with neutrophils. Neutrophil and mononuclear cell infiltration characterize endotoxin-induced uveitis in an animal model of acute anterior uveitis. Together, these data led us to speculate that neutrophils may play a role in the pathogenesis of anterior uveitis,” Angeles-Han says.

Since the paper was published, Cincinnati Children’s has provided internal funds to generate more pilot data to further pursue these findings. Validation in a large prospective cohort may better define the role of local inflammatory biomarkers in pediatric uveitis. These studies could lead to a non-invasive method of ocular screening of children with JIA and uveitis.