Sympathetic Ophthalmia

Damico, Francisco Max; Kiss, Szilárd; Young, Lucy H.

doi:10.1080/08820530500232100

Cited by 104 publications

(81 citation statements)

References 24 publications

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“…Such effects are not just limited to autoimmune diabetes. Thus, injury to one eye can initiate an autoimmune response that destroys the contralateral eye and ischemic necrosis of the heart can lead to an autoimmune pericarditis 16 17. In the case of tumours, injection of dead cancer cells can stimulate T-cell responses 9 .…”

Section: Danger and Diseasementioning

confidence: 99%

How dying cells alert the immune system to danger

2008

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When a cell dies in vivo the event does not go unnoticed. The host has evolved mechanisms to detect the death of cells and rapidly investigate the nature of their demise. If cell death is a result of natural causes, that is, it is part of normal physiological processes, then there is little threat to the organism. In this situation, little else is done other than removing the corpse. However, if cells have died as the consequence of some violence or disease, then both defence and repair mechanisms are mobilized. The importance of this process to host defence and disease pathogenesis has only been appreciated relatively recently. This article will review our current knowledge of these processes.The immune system was recognized in ancient times and rediscovered by Jenner and Pasteur based on its ability to confer protection upon repeat exposure to a pathogen. Through subsequent studies by Von Behring and others it rapidly became apparent that the immune system had the potential to respond not only to whole microorganisms, but to virtually any molecule that was "foreign" to the host. However, whereas injection of such molecules would often provoke a robust immune response, this did not invariably occur. Immunization protocols improved in the 1920s with the discovery by Ramon and Glenny of immunostimulatory molecules (adjuvants [G]) that could boost immune responses to co-administered antigens. Adjuvants were typically of microbial origin and became widely used to promote the effectiveness of immunizations. In the 1960s, Dresser showed that a foreign protein when highly purified would only elicit an immune response if it was admixed with a microbial adjuvant 1 . Injected by itself, the antigen not only failed to elicit immunity but actually induced a state of tolerance 2 . However, the significance of these observations was not well appreciated and adjuvants remained one of those things that everyone used because they were part of standard operating procedures.In 1989 Janeway put these empirical observations into a conceptual framework 3 (Fig. 1). He proposed that the immune system did not respond to all foreign antigens but only to those that are potentially associated with infection. The underlying idea here was that the immune system evolved to protect organisms against microorganisms and this discrimination between infectious versus noninfectious antigens focused defences on real threats rather than innocuous situations.At this time, it was already recognized that in order to stimulate T cell responses, antigens had to first be acquired and presented on MHC molecules of an antigen presenting cell (APC). Moreover, it was further known that APCs also provided additional costimulatory signals necessary to activate T cells. Janeway incorporated these principles into his model (Fig. 1). He postulated that the discrimination between infectious and noninfectious non-self molecules was made by the APCs of the innate immune system through receptors that would recognize pathogen-associated molecular patterns (PAMP...

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Section: Danger and Diseasementioning

confidence: 99%

How dying cells alert the immune system to danger

2008

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“…Understanding how to restore immune regulation in the face of immune inflammation might lead to novel therapeutic strategies for immediate intervention in patients with accidental laser burn or trauma to an eye and may prevent the appearance of sympathetic ophthalmia. Sympathetic ophthalmia is a condition in which trauma to one eye leads to immune inflammation and potentially blindness in the nontraumatized eye 51,52 because of a loss of its immune privilege. At the very least this puzzling situation might benefit from future studies exploiting RLB model as a model for sympathetic ophthalmia.…”

Section: Discussionmentioning

confidence: 99%

Retinal Laser Burn Disrupts Immune Privilege in the Eye

Qiao

Lucas

Stein‐Streilein

2009

The American Journal of Pathology

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Immune privilege allows for the immune protection of the eye in the absence of inflammation. Very few events are capable of overcoming the immune-privileged mechanisms in the eye. In this study, we report that retinal laser burn (RLB) abrogates immune privilege in both the burned and nonburned eye. As early as 6 hours after RLB, and as late as 56 days after RLB, antigen inoculation into the anterior chamber of the burned eye failed to induce peripheral tolerance. After RLB, aqueous humor samples harvested from nontreated eyes but not from either the burned or the contralateral eye, down-regulated the expression of CD40 and up-regulated interleukin-10 mRNA in peritoneal exudate cells, and converted peritoneal exudate cells into tolerogenic antigen-presenting cells (APCs). Unlike F4/80 ؉ APCs from nontreated mice, F4/80 ؉ APCs from RLB mice were unable to transfer tolerance after anterior chamber inoculation of antigen into naïve mice. The increased use of lasers in both the industrial and medical fields raises the risk of RLB-associated loss of immune regulation and an increased risk of immune inflammation in the eye.

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“…However in about 20% of cases diagnosis is confirmed based on histologic findings [15]. In vague cases, other causes of granulomatous uveitis, such as Vogt-Koyanagi-Harada disease, sarcoidosis, tuberculosis and syphilis should be considered and ruled out with appropriate diagnostic methods.…”

Section: Discussionmentioning

confidence: 99%

Sympathetic Ophthalmia

Demissie¹

2014

AOVS

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BackgroundSympathetic ophthalmia (SO) is a rare bilateral, diffuse granulomatous panuveitis that occurs following penetrating trauma or intraocular surgery to one eye, the exciting eye. The fellow non-traumatized sympathizing eye also shows similar inflammatory response usually with mutton-fat KPs suggesting involvement of autoimmune response [1]. Though the time from ocular injury to onset of SO was said to vary greatly, ranging from a few days to fifty years with 90% of the cases occurring within 1 year [2][3][4][5], recent series showed that only one-third of patients developed SO within 3 months and fewer than 50% did so within 1 year of injury [6].It has been speculated that an infectious agent or a bacterial antigen may precipitate an immune response resulting in the development of SO; but instigating organisms were not identified and the precise etiology of SO remains unknown to this time [5,7].The prevalence of SO is difficult to measure because it has always been a relatively rare disease plus as a result of improvements in modern surgical and medical treatments, it has now become even more uncommon. It accounted for about 0.3% of uveitis and its 1-year incidence was calculated to be a minimum of 0.03/100,000 population [8]. In a retrospective analysis of 2,340 cases of open-globe injuries in Iran, 0.08% (only two cases) was diagnosed with sympathetic ophthalmia from 1998 to 2003 [9].Patients with SO typically present with asymmetric bilateral panuveitis with more severe inflammation in the exciting eye than in the sympathizing eye at least initially. Signs and symptoms in the sympathizing eye vary in their severity and onset ranging from mild problem in near vision, photophobia and slight redness to very severe granulomatous anterior uveitis [5].Significant improvements in the management of ocular trauma combined with the advent of immune-modulators (including corticosteroids) and the use of antibiotics has led to a dramatic decrease in the incidence of sympathetic ophthalmia. However intraocular surgery is now considered the major risk factor particularly vitreoretinal surgery [10,11]. Case PresentationA 24-year-old male patient from Southwest Ethiopia presented to Jimma hospital eye department in March 2009 with pain and loss of right eye (OD) vision following trauma from a flying stone four months back. He was also having severe left eye (OS) pain associated with progressive reduction of vision, photophobia, redness and headache since three months. On examination, vision was no light perception (NLP) in OD and hand motion in OS. Intraocular pressure (IOP) was hypotonous in OD and 22mmHg in OS. The right eye was having hyperemic conjunctiva, irregular raised scleral scar nasally, hazy cornea, diffuse large KPs, shallow anterior chamber (A/C), irregular nonreactive pupil and contracted eyeball. In the left eye he was having ciliary flush, hazy cornea with endothelial dusting and many large KPs, A/C was deep, turbid aqueous with 4+ cells, sluggishly reactive pupil and limited lens and posterior segment...

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Sympathetic Ophthalmia

Cited by 104 publications

References 24 publications

How dying cells alert the immune system to danger

How dying cells alert the immune system to danger

Retinal Laser Burn Disrupts Immune Privilege in the Eye

Sympathetic Ophthalmia

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