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Serum cytokines as biomarkers for dry and wet age related macular degeneration

Background Age related macular degeneration (AMD) is the most common cause of irreversible visual loss in elderly individuals. Purpose The aim of this study was to identify the potential role of serum pro-inflammatory cytokines, including interleukin-13 (IL-13), IL-17, tumor necrosis factor-α (TNF-α), transforming growth factor β (TGF-β), and vascular endothelial growth factor (VEGF), in patients with AMD. Patients and methods The patients were divided into three groups: 20 patients with dry AMD, 20 patients with wet AMD before treatment with anti-VEGF injections, and 20 patients with wet AMD after anti-VEGF injections. Serum samples from patients with AMD and 20 age-matched controls were examined for the aforementioned cytokines using the ELISA technique. Results Serum levels of IL-13, IL-17, and TGF-β were significantly elevated in all patients with AMD compared with the controls (P=0.045, 0.047, and 0.042, respectively). There was a positive correlation (r=0.6, P=0.045) between the levels of IL-13 and TGF-β in these patients. In addition, the serum levels of TNF-α were significantly decreased in patients with AMD compared with the controls (P=0.037). The serum levels of IL-17 of the patients treated with anti-VEGF were significantly decreased compared with the untreated patients (P=0.032). In addition, the serum levels of TNF-α were significantly elevated in the treated patients compared with the untreated patients (P=0.024). There was no significant difference in the levels of IL-13, TGF-β, and VEGF in the treated patients compared with the untreated patients (P=0.07). Conclusion The study demonstrated that AMD is an inflammatory disease as patients with AMD had elevated levels of IL-13, IL-17, and TGF-β. In addition, serum IL-17 and TNF-α level could be significant predictors of the efficiency of anti-VEGF therapy. These findings may help in improvement of AMD diagnosis and may lead to the development of new therapeutic agents targeting these cytokines.