Download PDF
Klin Monbl Augenheilkd 2000; 216(5): 283-285
DOI: 10.1055/s-2000-10561
KLINISCHE STUDIE

Georg Thieme Verlag Stuttgart · New York

Antiretinale Antikörper assoziiert mit zystoidem Makulaödem1

Antiretinal antibodies and macular oedemaThomas  J. Wolfensberger1 , Nata Aptsiauri2 , Bernard Godley3 , Susie Downes4 , Alan  C. Bird4
  • 1 Hôpital Ophtalmique Jules Gonin, Université de Lausanne, 15, Av. de France, 1004 Lausanne, Suisse, E-mail: tjw@pingnet.ch
  • 1 (Direktor: Prof. Dr. L. Zografos)
  • 2 Dept. of Ophthalmology, University of Iowa, Iowa City, USA (Direktor: Prof. Dr. T. Weingeist)
  • 3 Dept. of Ophthalmology, Vitreoretinal Unit, University of Texas, Galveston, USA (Direktor: Prof. Dr. B. Godley)
  • 4 Moorfields Eye Hospital, Medical Retinal Department, London, England (Direktor: Mr. Zdenek Gregor, FRCS, FRCOphth)
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Fragestellung Kürzlich wurden anti-Enolase- und anti-Carboanhydrase-Antikörper in über 60 % bei Patienten mit Retinitis pigmentosa (RP) und zystoidem Makulaödem (CME) beschrieben. Wir untersuchten das Vorhandensein dieser Antikörper in einem Patientenkollektiv mit CME verschiedener Ätiologien.

Methoden In 10 Patienten mit CME wurden Serumantikörper gegen Carboanhydrase (CA) II (30 kD) und Enolase (46 kD) mittels Western Blots, Dot Blots sowie mit ELISA untersucht.

Resultate Western und Dot Blotting zeigte anti-CA-II-Antikörper in allen 10, sowie anti-Enolase-Antikörper in 6 Patienten. Der durchschnittliche mit ELISA gemessene Titer war 0,9 ± 0,1 OD Units (0,35 - 1,4) bei einer Verdünnung von 1 : 400.

Schlussfolgerung Das Vorhandensein von antiretinalen Antikörpern im Serum aller unserer Patienten bestätigt die beschriebene hohe Prävalenz dieser Antikörper bei Patienten mit CME. Dies könnte darauf hindeuten, dass eine Dysfunktion der CA und der Enolase-Aktivität im retinalen Pigmentepithel das Ödem begünstigt, während beim Fehlen dieser Antikörper andere Mechanismen verantwortlich sein könnten.

Aim Recently, anti-Enolase and anti-carbonic anhydrase antibodies have been observed in over 60 % of patients with retinitis pigmentosa (RP) and cystoid macular oedema (CME). We investigated the presence of these antibodies in a series of patients with CME due to different pathologies.

Methods In 10 patients with CME serum antibodies against Carbonic anhydrase (CA) II (30 kD) and Enolase (46 kD) were sought using Western Blots, Dot Blots as well as ELISA.

Results Western and dot blotting showed anti-CA II antibodies in all and anti-Enolase antibodies in six of the 10 patients. The average titer measured with ELISA was 0.9 ± 0.08 OD Units (0.35 - 1.4) with a dilution of 1 : 400.

Conclusion The presence of antiretinal antibodies in the serum of all patients confirms the high prevalence of these antibodies in patients with CME. This may suggest that a dysfunction of CA and enolase activity in the retinal pigment epithelium may lie at the root of oedema formation, whereas other mechanisms may be responsible in the absence of these antibodies.

Schlüsselwörter

Makulaödem - antiretinale Antikörper - Retinitis pigmentosa

Key words

Macular oedema - antiretinal antibodies - retinitis pigmentosa

Literatur

  • 01 Thirkill  C E, Roth  A M, Keltner  J L. Cancer-Associated Retinopathy.  Arch Ophthalmol. 1987;  105: 372-375
    Search in Google Scholar
  • 02 Heckenlively  J R, Solish  A M, Chant  S M, Meyers-Elliott  R H. Autoimmunity in hereditary retinal degenerations. II. Clinical studies: antiretinal antibodies and fluorescein angiogram findings.  Br J Ophthalmol. 1985;  69: 758-764
    Search in Google Scholar
  • 03 Adamus  G, Aptsiauri  N, Guy  J, Heckenlively  J R, Flannery  J, Hargrave  P A. The occurrence of serum autoantibodies against enolase in cancer associated retinopathy.  Clin Immunol Immunopath. 1996;  28: 120-129
    Search in Google Scholar
  • 04 Heckenlively  J R, Aptsiauri  N, Nusinowitz  S, Peng  C, Hargrave  P A. Investigations of antiretinal antibodies in pigmentary retinopathy and other retinal degenerations.  Trans Am Ophthalmol Soc. 1996;  94: 179-200
    Search in Google Scholar
  • 05 Wolfensberger  T J, Chiang  R, Takeuchi  A, Marmor  M F. Inhibition of membrane-bound carbonic anhydrase enhances subretinal fluid absorption and retinal adhesiveness.  Graefes Arch Clin Exp Ophthalmol. 2000;  238: 76-80
    Search in Google Scholar
  • 06 Wolfensberger  T J, Dimitriev  A V, Govardovskii  V I. Inhibition of membrane-bound carbonic anhydrase decreases subretinal volume and pH.  Doc Ophthalmol. 2000;  in press
    Search in Google Scholar
  • 07 Nork  T M, McCormick  S A, Chao  G M, Odom  V. Distribution of carbonic anhydrase among human photoreceptors.  Invest Ophthalmol Vis Sci. 1990;  31: 1451-1458
    Search in Google Scholar
  • 08 Wolfensberger  T J, Mahieu  I, Jarvis-Evans  J, et al. Membrane-Bound Carbonic Anhydrase in Human Retinal Pigment Epithelium.  Invest Ophthalmol Vis Sci. 1994;  35: 3401-3407
    Search in Google Scholar
  • 09 Rogers  S W, Andrews  P I, Gahring  L C, et al. Autoantibodies to glutamate receptor GluR3 in Rasmussen's encephalitis.  Science. 1994;  265: 648-651
    Search in Google Scholar
  • 10 Jackson  J, Feighery  C. Autoimmune angioedema: a new role for autoantibody in disease pathogenesis.  Autoimmunity. 1990;  7: 181-187
    PubMedSearch in Google Scholar
  • 11 Küchle  M, Nguyen  N X, Schalnus  R, Freissler  K, Luchtenberg  M, Muller  M. Quantification of disorders of the blood-aqueous humor barrier in retinitis pigmentosa, initial results.  Klin Monatsbl Augenheilkd. 1994;  204: 211-216
    PubMedSearch in Google Scholar
  • 12 Vinores  S A, Kuchle  M, Derevjanik  N L, et al. Blood-retinal barrier breakdown in retinitis pigmentosa: light and electron microscopic immunolocalization.  Histol Histopathol. 1995;  10: 913-923
    PubMedSearch in Google Scholar
  • 13 Cox  S N, Hay  E, Bird  A C. Treatment of chronic macular edema with acetazolamide.  Arch Ophthalmol. 1988;  106: 1190-1195
    PubMedSearch in Google Scholar
  • 14 Wolfensberger  T J, Godley  B, Downes  S, et al. Treatment of cystoid macular edema with acetazolamide and benzolamide: a prospective double-blind, placebo-controlled cross-over trial.  Invest Ophthalmol Vis Sci. 1997;  38: 4320
    PubMedSearch in Google Scholar