Immunoregulation of retinal ganglion cell fate in glaucoma.
Glaucomatous neurodegeneration has been associated with the activation of multiple pathogenic mechanisms that can result in RGC death and axonal degeneration. Growing evidence obtained from clinical and experimental studies over the last decade also strongly suggests the involvement of the immune system in the neurodegenerative process of glaucoma. The roles of the immune system in glaucoma have been described as either neuroprotective or neurodestructive. It has been proposed that a critical balance between beneficial protective immunity and harmful sequelae of autoimmune neurodegenerative injury determines the ultimate fate of RGCs in response to various stressors in patients with glaucoma. Here, we review the key role for immunoregulation in cell fate decisions regarding RGC survival in response to glaucomatous tissue stress. Furthermore, we review the mechanisms by which autoimmunity to specific antigens such as heat shock proteins may result in RGC demise in some patients with glaucoma. In these patients, we hypothesized that one form of glaucoma may be an autoimmune optic neuropathy in which an individual's immune system facilitates a somatic or axonal degeneration of RGCs by the very system which normally serves to protect it against stress.
Wax
Martin B
MB
Department of Ophthalmology and Visual Sciences, University of Texas, Southwestern Medical School, Dallas, TX 75390-9057, USA. mbw817@yahoo.com
Tezel
Gülgün
G
D015551:Autoimmunity; D001369:Axons / Q000473:pathology; D016923:Cell Death / Q000276:immunology; D016207:Cytokines / Q000276:immunology; D005901:Glaucoma / Q000276:immunology* / Q000473:pathology; D006360:Heat-Shock Proteins / Q000276:immunology; D006801:Humans; D018836:Inflammation Mediators / Q000276:immunology; D018384:Oxidative Stress / Q000276:immunology; D012165:Retinal Ganglion Cells / Q000276:immunology* / Q000473:pathology
D016207:Cytokines; D006360:Heat-Shock Proteins; D018836:Inflammation Mediators