Intraocular inflammatory disease (uveitis) and the use of oral tolerance: a status report.
Intraocular inflammatory disease, or uveitis, is a disorder that mostly affects children and young adults. It is the cause of about 10% of the severe visual handicap in the United States. Many of the severe, sight-threatening uveitic conditions are thought to be driven by putative autoimmune mechanisms, often with high-dose oral prednisone use as treatment, along with cytotoxic agents, antimetabolites, and cyclosporine adjunctively. The feeding of the uveitogenic retinal S-Ag to rats immunized with the same antigen resulted in clinical protection. A pilot study in which two patients, one with pars planitis and the other with Behcet's disease, were fed with the retinal S-Ag resulted in these patients' immunosuppressive medication being decreased and/or stopped. The trial also provided us with information concerning dosage and expected immune responses. A randomized, masked study looking at the effect of feeding retinal antigens to uveitis patients is ongoing.
Nussenblatt
R B
RB
Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
Whitcup
S M
SM
de Smet
M D
MD
Caspi
R R
RR
Kozhich
A T
AT
Weiner
H L
HL
Vistica
B
B
Gery
I
I
D000284:Administration, Oral; D000328:Adult; D000818:Animals; D000941:Antigens / Q000008:administration & dosage* / Q000276:immunology; D019393:Arrestin; D001324:Autoantigens / Q000008:administration & dosage / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002478:Cells, Cultured; D002648:Child; D002986:Clinical Trials as Topic; D005136:Eye Proteins / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D008198:Lymph Nodes / Q000276:immunology; D008213:Lymphocyte Activation; D051379:Mice; D010865:Pilot Projects; D051381:Rats; D011917:Rats, Inbred Lew; D014605:Uveitis / Q000276:immunology* / Q000517:prevention & control* / Q000628:therapy
D000941:Antigens; D019393:Arrestin; D001324:Autoantigens; D005136:Eye Proteins