@article {1417572,
	title = {Blood Levels of Tumor Necrosis Factor Alpha and Its Type 2 Receptor Are Elevated in Patients with Boston Type I Keratoprosthesis},
	journal = {Curr Eye Res},
	volume = {44},
	number = {6},
	year = {2019},
	month = {2019 Jun},
	pages = {599-606},
	abstract = {: Boston keratoprosthesis (KPro) patients are prone to glaucoma even with well-controlled intraocular pressure (IOP). Recent experimental data have shown that soluble tumor necrosis factor alpha (TNF-) after ocular injury may contribute to progressive retinal damage and subsequent glaucoma. This study evaluates the blood plasma levels of soluble TNF-, TNF receptors 1 (TNFR1) and 2 (TNFR2), and leptin in patients with Boston type I KPro. : Venous blood samples were collected from KPro patients with glaucoma (KPro G, =\&nbsp;19), KPro patients without glaucoma (KPro NoG, =\&nbsp;12), primary angle closure glaucoma without KPro (PACG, =\&nbsp;13), and narrow angles without glaucoma or KPro (NA, =\&nbsp;21). TNF-, TNFR1, TNFR2, and leptin levels were quantified using the enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate (ESR) was assessed using the Westergren test. Patients with underlying autoimmune conditions or diabetes were excluded from the study. : All groups had similar age, body mass index (BMI), IOP, and ESR ( >=\&nbsp;0.11). The mean time from KPro surgery to blood draw was 5.3\&nbsp;{\textpm}\&nbsp;3.7\&nbsp;years. Compared to NA patients (0.72\&nbsp;{\textpm}\&nbsp;0.3\&nbsp;pg/ml), KPro G and KPro NoG patients had higher blood plasma levels of TNF- (1.18\&nbsp;{\textpm}\&nbsp;0.58\&nbsp;pg/ml, =\&nbsp;0.006; 1.16\&nbsp;{\textpm}\&nbsp;0.50\&nbsp;pg/ml, =\&nbsp;0.04, respectively). Similarly, KPro G patients had higher blood plasma levels of TNFR2 (2768\&nbsp;{\textpm}\&nbsp;1368\&nbsp;pg/ml) than NA patients (2020\&nbsp;{\textpm}\&nbsp;435\&nbsp;pg/ml, =\&nbsp;0.048). In multivariate analysis, KPro status remained positively associated with TNF- levels (\&nbsp;=\&nbsp;0.36; 95\% confidence intervals [CI]: 0.14-0.58; =\&nbsp;0.002) and TNFR2 levels (\&nbsp;=\&nbsp;458.3; 95\% CI: 32.8-883.7; =\&nbsp;0.035) after adjusting for age, gender, BMI, glaucoma status, and ESR. TNFR1 and leptin levels were not significantly different in the study groups. : We detected elevated serum levels of TNF- and TNFR2 in KPro patients. Longitudinal studies are needed to establish TNF- and TNFR2 as serum biomarkers related to KPro surgery. : BCVA: best corrected visual acuity; BMI: body mass index; CDR: cup-to-disc ratio; EDTA: ethylenediaminetetraacetic acid; ELISA: enzyme-linked immunosorbent assay; ESR: erythrocyte sedimentation rate; HVF: Humphrey visual field; IOP: intraocular pressure; KPro G: keratoprosthesis with glaucoma; KPro NoG: keratoprosthesis without glaucoma; KPro: keratoprosthesis; MD: mean deviation; NA: narrow angle; non-KPro: without keratoprosthesis; PACG: primary angle closure glaucoma; RNFL: retinal nerve fiber layer; TNF-α: tumor necrosis factor alpha; TNFR1: tumor necrosis factor receptor 1; TNFR2: tumor necrosis factor receptor 2.},
	issn = {1460-2202},
	doi = {10.1080/02713683.2019.1568500},
	author = {Paschalis, Eleftherios I and Taniguchi, Elise V and Chodosh, James and Pasquale, Louis R and Colby, Kathryn and Dohlman, Claes H and Shen, Lucy Q}
}
