Schwartz Michal, London Anat
Department of Neurobiology, The Weizmann Institute of Science, Rehovot, Israel.
J Ocul Biol Dis Infor. 2009 Sep;2(3):104-108. doi: 10.1007/s12177-009-9037-3. Epub 2009 Sep 23.
Glaucoma, a slow progressive neurodegenerative disorder associated with death of retinal ganglion cells and degeneration of their connected optic nerve fibers, has been classically linked to high intraocular pressure. Regardless of the primary risk factor, degeneration may continue, resulting in further loss of neurons and subsequent glaucomatous damage. During the past decade, scientists and clinicians began to accept that, in addition or as an alternative to fighting off the primary risk factor(s), there is a need to protect the tissue from the ongoing spread of damage-an approach collectively termed "neuroprotection." We found that the immune system, the body's own defense mechanism, plays a key role in the ability of the optic nerve and the retina to withstand glaucomatous conditions. This defense involves recruitment of both innate and adaptive immune cells that together create a protective niche and thereby halt disease progression. The spontaneous immune response might not be sufficient, and therefore, we suggest boosting it by immunization (with the appropriate antigen, at specific timing and predetermined optimal dosing) which may be developed into a suitable therapeutic vaccination to treat glaucoma. This view of immune system involvement in glaucoma will raise new challenges in glaucoma research, changing the way in which clinicians perceive the disease and the approach to therapy.[This corrects the article on p. in vol. .].
青光眼是一种与视网膜神经节细胞死亡及其相连的视神经纤维变性相关的缓慢进行性神经退行性疾病,传统上一直被认为与高眼压有关。无论主要危险因素如何,神经变性可能会持续,导致神经元进一步丧失和随后的青光眼性损害。在过去十年中,科学家和临床医生开始认识到,除了对抗主要危险因素或作为对抗主要危险因素的替代方法外,还需要保护组织免受持续的损伤扩散——这种方法统称为“神经保护”。我们发现,免疫系统,即人体自身的防御机制,在视神经和视网膜抵抗青光眼病情的能力中起着关键作用。这种防御涉及先天免疫细胞和适应性免疫细胞的募集,它们共同形成一个保护性微环境,从而阻止疾病进展。自发的免疫反应可能不够充分,因此,我们建议通过免疫接种(使用适当的抗原,在特定时间和预定的最佳剂量下)来增强免疫反应,这可能会发展成为一种合适的治疗性疫苗来治疗青光眼。这种免疫系统参与青光眼的观点将给青光眼研究带来新的挑战,改变临床医生对该疾病的认识方式和治疗方法。[这更正了第卷第页上的文章。]