A comparative study of of T regulatory cells numbers (CD4⁺CD25^highFoxP3⁺CD127^low) in patients under 1 year of age with cataract, glaucoma, and retinopathy of prematurity (review of the own studies)

Potential involvement of immune system in pathophysiology of congenital glaucoma, cataract, and retinopathy of prematurity (ROP) in infants has been suggested. However, its understanding still remains limited. T regulatory cells (CD4⁺CD25^highFoxP3⁺CD127^low), with their role in autoimmunity, are considered pivotal in this respect, although there is a scarcity of publications in this context. This study aims to address this gap. Our purpose was to compare the levels of blood cells with (CD4⁺CD25^highFoxP3⁺CD127^low) phenotype in infants with ROP, congenital glaucoma and cataract, and healthy full-term infants. This retrospective case-control study included 131 infants (262 eyes). Inclusion criteria were as follows: age under 12 months and a confirmed diagnosis of congenital cataract (20 eyes), congenital glaucoma (21 eyes), and ROP (158 eyes). The control group consisted of 27 full-term infants (54 eyes) with normal eye exam. Primary outcomes included study of Treg cells (CD4⁺CD25^highFoxP3⁺CD127^low) levels in all groups. Secondary outcomes involved the correlation between the CD4⁺CD25^highFoxP3⁺CD127^low subpopulation and weight at birth. According to our previous studies and when comparing the results in the present study of children under 1 year of age, we found significant differences in the number of T regulatory cells (CD4⁺CD25^highFoxP3⁺CD127^low) between premature and full-term children, as well as in the patient groups with cataract and glaucoma by their weight category. The authors were able to detect differences between stages of retinopathy of prematurity by the number of T regulatory cells (CD4⁺CD25^highFoxP3⁺CD127^low), distinguishing posterior aggressive retinopathy of prematurity as a special form of this pathology. The reduced levels of CD4⁺CD25^highFoxP3⁺CD127^low cells in infants with ROP type 1 suggests autoimmune reactions in its pathophysiology. The remarkable difference in (CD4⁺CD25^highFoxP3⁺CD127^low) Treg cells in patients with congenital glaucoma and cataract may indicate immune-mediated mechanisms in their development. The clinical significance of the revealed correlation between the level of studied T cells and birth weight in infants with cataract and glaucoma is not clear and requires further investigation with regard to the disease severity. The index can be used as a potential prognostic marker of the disease course and visual outcomes. Collectively, this study provided valuable insights on the potential targets for novel treatment strategies in infants with ROP, glaucoma, and cataracts.

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