Immunological mechanisms in glaucoma

Abstract

Glaucoma is one of the most frequent causes of blindness worldwide. The elevated intraocular pressure does not explain glaucoma in all patients but can be considered as a risk factor of the disease. There are some evidences that autoimmune mechanisms may be involved in this disorder. This review attempts to demonstrate the findings about autoimmune mechanisms in glaucoma patients. Consistent up- and down-regulations in the autoantibody profiles against ocular antigens are present in glaucoma patients. These changes in natural autoimmunity could be found in independent study populations and might be a promising tool for glaucoma detection.

Western blot patterns of serum autoantibodies against optic nerve antigens in dogs with goniodysgenesis-related glaucoma

“…8–15,43,44,49–54 Given that an increase in the reactivity associated with specific autoantibodies can exist in humans with other autoimmune diseases for extended periods prior to onset of symptoms, this information may be useful in developing screening tools and treatments for glaucoma. 3,55–57 …”

“…Autoimmune responses generated in response to insults can in some situations be protective or play a role in reestablishing homeostasis, sometimes via pathways other than typical antigen-antibody interactions. 3,58,59 Several studies have been performed to evaluate broader patterns of serum and aqueous humor autoantibodies against retinal and optic nerve antigens in glaucomatous humans with digests of those tissues as antigen sources. In people, serum and aqueous humor autoantibody patterns differ significantly between individuals with and without glaucoma and across various categories of disease, including primary open-angle glaucoma, normal-tension glaucoma, and ocular hypertension without glaucoma.…”

“…3–6 In particular, several studies 7–15 have been performed to evaluate changes in serum autoantibody profiles against retinal and optic nerve antigens in glaucomatous humans, through use of a western blot–based technique with retinal or optic nerve digests as antigen sources. These studies have revealed significant differences, involving both increases and decreases in autoreactivity, between healthy people and people with glaucoma.…”

Insights into the Immune System and Glaucoma

“…Findings from numerous studies support the notion that both the innate and adaptive immune responses are involved in the pathogenesis of glaucoma. 1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Yet, the precise mechanisms of immune responses and the specific cell interactions contributing to the disease process are still not fully understood. Many questions remain about the role of the immune system in glaucoma ( Figure 1).…”

“…1,2,17,18 Studies have shown the presence of autoantibodies against ocular antigens such a rhodopsin and glycosaminoglycans (GAGs). 1,7,[38][39][40] It has been revealed that patients with normal tension glaucoma have increased levels of heat shock proteins, such as heat shock protein 60 (HSP 60), due to excessive tissue stress and damage. 17,18,[41][42][43] But there is no direct evidence to confirm that RGC loss is due to humoral immunity in glaucoma.…”