Local production of IgG and IgG subclasses in the aqueous humor of patients with Fuchs heterochromic cyclitis, herpetic uveitis and toxoplasmic chorioretinitis.

Changes in local immunity are important when considering the physiopathology of uveitis. The aim of this study was to measure IgG and IgG subclass concentrations in the serum and the AH of patients with three different types of uveitis and to determine for each of them the presence of a local production of IgG in the intra-ocular compartment. This investigation was extended to IgG subclasses. Serum and AH of 46 patients, including 11 with Fuchs heterochromic cyclitis (FHC), 13 with toxoplasmic chorioretinitis, 11 with herpetic uveitis and 11 with senile cataract (taken as controls) were analyzed by ELISA for IgG and IgG subclasses. Three quotients (r1, IgG/albumin in serum; r2, IgG/albumin in AH; and R, r2/r1) were calculated in order to estimate the local synthesis (LS) of IgG and each IgG subclass. In AH of patients with herpetic uveitis, a concomitant and significant increase of all IgG subclasses as well as albumin (with no significant increase of r2 or R) was observed. This finding was interpreted as an indirect consequence of major damage to the blood-aqueous barrier. In patients with FHC, a significant increase of r2 and R involving only the IgG1 subclass was observed, indicating the existence of LS of IgG1 in the majority of these patients. In the AH of patients with toxoplasmic chorioretinitis, no significant modification of IgG subclass or albumin concentrations was observed when compared to controls. In conclusion, it would seem interesting to consider measurement of IgG and IgG subclasses and calculation of the coefficients r1, r2 and R for a better evaluation of the local immunological processes observed in different types of uveitis.