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  • Serum protein measurements may show the need for immunomodulators in NIU

    Uveitis

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    Review of: A network of serum proteins predict the need for systemic immunomodulatory therapy at diagnosis in noninfectious uveitis

    Kuiper J, Verhagen F, Hiddingh S, et al. Ophthalmology Science, September 2022

    A multicenter cohort study investigated whether the proteomic signature of a patient with noninfectious uveitis (NIU) can predict the need for systemic immunomodulatory therapy (IMT).

    Study design

    Fifty-four Dutch patients with active noninfectious uveitis and 26 healthy control participants were enrolled in the study. An aptamer-based technology was used to analyze 1305 serum proteins in total. The study results were independently validated with data from 2 additional patient cohorts.

    Outcomes

    There was a greater serum proteome cluster concentration found in patients with active NIU compared with healthy controls. The need for IMT was significantly higher among patients with high levels of the serum protein network linked to blood neutrophil counts during follow-up. Separate analyses of the additional patient cohorts found that neutrophil counts of >5.2 × 109/L at uveitis onset was highly predictive of the need for IMT during follow-up.

    Limitations

    An absence of systemic treatment at the time of sampling for all cohort participants did not allow for an accurate prediction as to whether these findings are applicable for patients who already receive IMT treatment.

    Clinical significance

    A neutrophil count is a simple-to-assess and widely available test that can be used for stratification of patients with active NIU who are not receiving systemic treatment. Further studies are needed to understand if the neutrophil blood count during periodic workup can be used for assessment of disease severity and prediction for safe tapering of medications.