PURPOSE:: The purpose of this study was to determine the cytokine-related pathogenesis of human immunodeficiency virus retinopathy in human autopsy eyes. METHODS:: Fresh autopsy eyes were procured from clinically diagnosed patients with acquired immunodeficiency syndrome who had died as a result of disease-related complications; eyes were immediately immersed in RNAlater. Clean 2-mm trephines were used to punch individual pathologic retina in areas of cotton-wool spots and control punches. Total RNA was extracted using the TRIzol extraction protocol, and the optimal density of the RNA was measured at an optical density of 260 nm. [Delta]Ct (cytokine) values were calculated using the comparative cytokine analysis method. The results are expressed as a mean fold modulation and as a statistical comparison of Ct values controlling for retinal areas without a lesion in the same eye. RESULTS:: The fold modulations and the statistical comparisons of the cytokines studied in tissues from cotton-wool spots and control retina, respectively, regulated on activation normal T cell expressed and secreted (RANTES), macrophage inflammatory protein 1β, macrophage inflammatory protein 1α (5.32×, P = 0.04), and Bcl-2-associated X protein (1.24×, P = 0.05) had a marked elevation of fold modulation and were statistically significant compared with control tissue. Interleukin-8 (1.09×, P = 0.18), interleukin-4, and interleukin-10 (2.7×, P = 0.30) were not significantly expressed in cotton-wool spots. CONCLUSION:: Certain inflammatory human immunodeficiency virus-associated and apoptotic cytokines are expressed in cottonwool spots in eyes with human immunodeficiency virus retinopathy.
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