OBJECTIVE To assess the role of CD3+ CD20+ CD4- CD8- double-negative (DN) or CD3+CD20+ CD4/CD8+ T cells and the related pro-inflammatory cytokines in the humor aqueous, in mediating retinal microvascular changes in patients with chronic plaque-type moderate to severe psoriasis. DESIGN A total of 76 patients (57.6 ± 11.7 years) with chronic plaque-type psoriasis were initially evaluated. Nineteen patients (19 eyes) and 19 healthy volunteers (19 eyes) were subjected to dermatological evaluation with Psoriasis Area Severity Index (PASI) and the Dermatology life quality index (DLQI). Retinal images were processed using an automatized software. On the same day, a venous sample was collected and analyzed using multiparametric flow cytometry. Three out of 6 patients who presented cataract, consented to perform surgery with humor aqueous collection. The samples were analyzed using a Multi-Analyte ELISA kit for the simultaneous quantification of IL1α, IL1β, IL2, IL4, IL6, IL8, IL10, IL12, IL17A, IFNγ, TNF-α, GMCSF. RESULTS The CD3+CD4+/CD8+CD20+CD56- T cells expression was greater in the psoriatic patients (+73.9%, P < 0.001) compared to controls, but not the DN T cells (-8.2%, P = 0.30). Ocular complications were diagnosed in 61.1% of patients, microvascular parameters including artero-venous ratio (P = 0.04), subfoveal choriocapillaris/Sattler's layer, and choroidal thickness (CT, both P < 0.001) were significantly altered in psoriasis subgroup. The increased circulating levels of the CD3+CD4+/CD8+CD20+CD56- T cells were associated with thinning of subfoveal CT (P = 0.03) and Haller's layer (P = 0.01). Instead, the DN T cells presented an inverse relationship with disease duration (P = 0.02), DLQI score (P = 0.02), and the use of biological therapy (P = 0.05). The related cytokine patterns possibly modified in this cellular context have been investigated. No significant differences were observed in cytokines levels between psoriasis and controls, the most significant difference was detected on IL-6, without reaching statistical significance (fold change of 1.4, P = 0.13). CONCLUSION Our findings demonstrated that CD20+ T cell subpopulation is highly represented in psoriasis regardless of the use of immunomodulatory therapies, and the diffuse microvascular alterations suggested possible endothelial damage as mainstream for the genesis of psoriatic-mediated complications as further supported by the comparable concentrations of cytokines, at least as humor aqueous content, with respect to healthy eyes.

中文翻译：

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CD 20+ T细胞和相关细胞因子在介导慢性斑块型银屑病视网膜微血管变化和眼部并发症中的作用

目的 评估 CD3+ CD20+ CD4- CD8- 双阴性 (DN) 或 CD3+CD20+ CD4/CD8+ T 细胞和房水中相关促炎细胞因子在介导慢性斑块患者视网膜微血管变化中的作用。类型中度至重度银屑病。设计 最初对总共 76 名患有慢性斑块型银屑病的患者（57.6 ± 11.7 岁）进行了评估。19 名患者（19 只眼）和 19 名健康志愿者（19 只眼）接受了牛皮癣面积严重程度指数 (PASI) 和皮肤病生活质量指数 (DLQI) 的皮肤病学评估。使用自动化软件处理视网膜图像。同一天，收集静脉样本并使用多参数流式细胞术进行分析。6 名出现白内障的患者中有 3 名同意进行收集体液的手术。使用 Multi-Analyte ELISA 试剂盒分析样品，以同时定量 IL1α、IL1β、IL2、IL4、IL6、IL8、IL10、IL12、IL17A、IFNγ、TNF-α、GMCSF。结果与对照组相比，银屑病患者的 CD3+CD4+/CD8+CD20+CD56-T 细胞表达更高（+73.9%，P < 0.001），但与 DN T 细胞相比则不然（-8.2%，P = 0.30）。61.1% 的患者诊断出眼部并发症，银屑病亚组的微血管参数包括动静脉比（P = 0.04）、中心凹下脉络膜毛细血管/Sattler 层和脉络膜厚度（CT，均 P < 0.001）显着改变。CD3+CD4+/CD8+CD20+CD56-T 细胞循环水平的增加与中心凹下 CT (P = 0.03) 和 Haller 层 (P = 0.01) 变薄有关。反而，DN T 细胞与病程 (P = 0.02)、DLQI 评分 (P = 0.02) 和生物治疗的使用 (P = 0.05) 呈负相关。已经研究了可能在这种细胞环境中修饰的相关细胞因子模式。在银屑病和对照之间没有观察到细胞因子水平的显着差异，在 IL-6 上检测到最显着的差异，没有达到统计学显着性（倍数变化为 1.4，P = 0.13）。结论 我们的研究结果表明，无论是否使用免疫调节疗法，CD20+ T 细胞亚群在银屑病中都有很高的代表性，并且弥散性微血管改变表明可能的内皮损伤是银屑病介导的并发症发生的主流，可比浓度的细胞因子进一步支持,