Age-related macular degeneration and the immune response: implications for therapy.
OBJECTIVE
To review the available information concerning the immune mediation of age-related macular degeneration (AMD) and to speculate on proposed mechanisms and immunotherapy.


METHODS
Interpretative essay.


METHODS
Literature review and interpretation.


RESULTS
An ever-growing body of evidence is gathering concerning the role of the immune system in AMD. Evidence to date suggests that the underlying mechanism leading to AMD is the decline of the ocular downregulatory immune environment. The subsequent activation of the immune system would lead to T-cell sensitization. When combined with local antiangiogenic therapy, several existing immunotherapies may be used to downregulate the immune response, potentially leading to a more efficient inhibition of choroidal neovascularization.


CONCLUSIONS
The loss of the downregulatory immune environment is central to the development of AMD, permitting activation of the immune system. If so, immunotherapy could positively alter the course of the disease.
Nussenblatt
Robert B
RB
Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. DrBob@nei.nih.gov
Ferris
Frederick
F
D015551:Autoimmunity / Q000502:physiology; D006801:Humans; D007107:Immune System / Q000502:physiology*; D007167:Immunotherapy; D008268:Macular Degeneration / Q000276:immunology* / Q000628:therapy; D013601:T-Lymphocytes / Q000276:immunology
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