[Neuroendocrine response in patients with uveitis]

Uveitis is a group of inflammatory eye diseases whose origin is not yet known. It is supposed that they are autoimmune diseases, mediated by T cells, but the triggering mechanism is unknown. In the past few years the role of prolactin, as an immunomodulator, has been investigated. Its effect on cellular and humoral immunity has been brought in evidence by the presence of its receptors on the surface of immune cells. It has also been shown, that the presence of PRL is necessary for proliferation and maturation of immune cells. On the other hand, PRL-like molecule, whose effect is similar to that of pituitary PRL, is secreted by human lymphoid tissue as well as by peripheral mononuclear cells. The role of glucocorticoids in immunomodulation is based on their effects on immune system by inhibition of production of immune cells and their products, cytokines. Cytokines, which are produced during the immune reactions mediated by T cells, demonstrate their effect in autocrine and paracrine fashion, but when delivered in higher concentrations, can be found in blood, when they act at the hypothalamo-pituitary level. There are three opinions how they act at this level. The aim of the study was to investigate the role of prolactin and cortisol in the development of endogenous uveitis. The prospective study comprised 42 patients suffering from endogenous uveitis. Ten patients were controls. Prolactin concentrations were within normals, while cortisol concentrations were significantly decreased. We speculated the possible causes of such conditions, supposing that the hypothalamo-pituitary-adrenal axis disturbance could be the one. In conclusion, we would like to emphasize that in uveitis there is a disturbance at neuroendocrine/immune system level, and that uveitis is a systemic disease with ocular manifestation.