title: Age-related macular degeneration in the aspect of chronic low-grade inflammation (pathophysiological parainflammation).
abstract: The products of oxidative stress trigger chronic low-grade inflammation (pathophysiological parainflammation) process in AMD patients. In early AMD, soft drusen contain many mediators of chronic low-grade inflammation such as C-reactive protein, adducts of the carboxyethylpyrrole protein, immunoglobulins, and acute phase molecules, as well as the complement-related proteins C3a, C5a, C5, C5b-9, CFH, CD35, and CD46. The complement system, mainly alternative pathway, mediates chronic autologous pathophysiological parainflammation in dry and exudative AMD, especially in the Y402H gene polymorphism, which causes hypofunction/lack of the protective complement factor H (CFH) and facilitates chronic inflammation mediated by C-reactive protein (CRP). Microglial activation induces photoreceptor cells injury and leads to the development of dry AMD. Many autoantibodies (antibodies against alpha beta crystallin, alpha-actinin, amyloid, C1q, chondroitin, collagen I, collagen III, collagen IV, elastin, fibronectin, heparan sulfate, histone H2A, histone H2B, hyaluronic acid, laminin, proteoglycan, vimentin, vitronectin, and aldolase C and pyruvate kinase M2) and overexpression of Fcc receptors play role in immune-mediated inflammation in AMD patients and in animal model. Macrophages infiltration of retinal/choroidal interface acts as protective factor in early AMD (M2 phenotype macrophages); however it acts as proinflammatory and proangiogenic factor in advanced AMD (M1 and M2 phenotype macrophages).
authors.affiliation: Domestic and Specialized Medicine Centre "Dilmed", Bohaterów Monte Cassino 3, 40-231 Katowice, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Nita
authors.affiliation: Department of Ophthalmology, University of Warmia and Mazury, Al. Warszawska 30, 10-082 Olsztyn, Poland ; Department of Ophthalmology, Jozef Strus Poznan City Hospital, 3 Szwajcarska Street 61-285 Poznan, Poland.
authors.forename: Andrzej
authors.identifier: 0000-0002-3724-2391
authors.initials: A
authors.lastname: Grzybowski
authors.affiliation: Department of Ophthalmology, "Lozano Blesa" University Clinic Hospital, 50009 Zaragoza, Spain ; Aragon Health Sciences Institute, 50009 Zaragoza, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Ascaso
authors.affiliation: Department of Ophthalmology, University Hospital Arnau de Vilanova, 25198 Lleida, Spain ; IRB-Lleida, 25198 Lleida, Spain.
authors.forename: Valentín
authors.initials: V
authors.lastname: Huerva
mesh_terms: D001323:Autoantibodies / Q000378:metabolism; D017242:Complement Factor H / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008268:Macular Degeneration / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*
chemical_list: D001323:Autoantibodies; D017242:Complement Factor H