Kubicka-Trzaska Agnieszka, Wilańska Joanna
Katedra Okulistyki, Klinika Okulistyki i Onkologii Okulistycznej, Uniwersytet Jagielloński Collegium Medicum, Kraków.
Przegl Lek. 2009;66(11):944-7.
Age-related macular degeneration (AMD) is the leading cause of blindness in the Western world. Despite the magnitude of this clinical problem, the pathogenesis of the disease remains still unclear.
To determine the tissue specificity and titer of antiretinal antibodies (ARA) in sera of patients with exudative AMD.
Forty-six patients (92 eyes) 16 males and 30 women with exudative AMD were stratified arbitrary into four groups of AMD activity/severity: group I (n = 19)--patients with active choroidal neovascularization (CNV) in one eye and with drusen in the other eye; group II (n = 14)--patients with bilateral CNV; group III (n = 10)--patients with CNV in one eye and with disciform scar in the contralateral eye; group IV (n = 3)--patients with bilateral disciform scars. In all patients serum ARA were determined using indirect immunofluorescence detection on normal monkey retina as antigens substrate and FITC--labelled goat's anti-human IgA, G, M serum as the secondary antibody.
In all patients' serum ARA were present in the range of titres from 1:40 to 1:5120. Control sera (n = 28, 28 males) demonstrated the presence of ARA in titres 1:10 to 1:40 in 46.4% cases. High serum titres of ARA characterized AMD patients with bilateral CNV and CNV in one eye and drusen in the contralateral eye. Low titres of ARA were detected in serum of patients with bilateral disciform scars. Indirect immunofluorescence (IIF) showed eight types histological patterns of patients' sera reactivity against retinal tissue. No correlation was found between serum ARA type and macular lesion activity.
Our preliminary observations indicate a common presence of various ARA in serum of patients with AMD. Thus, it cannot exclude that ARA are involved in the pathogenesis or progression of AMD.
年龄相关性黄斑变性（AMD）是西方世界失明的主要原因。尽管这一临床问题严重，但该病的发病机制仍不清楚。
确定渗出性AMD患者血清中抗视网膜抗体（ARA）的组织特异性和滴度。
46例（92只眼）渗出性AMD患者，其中男性16例，女性30例，根据AMD活动度/严重程度任意分为四组：Ⅰ组（n = 19）——一只眼有活动性脉络膜新生血管（CNV），另一只眼有玻璃膜疣的患者；Ⅱ组（n = 14）——双侧CNV患者；Ⅲ组（n = 10）——一只眼有CNV，对侧眼有盘状瘢痕的患者；Ⅳ组（n = 3）——双侧盘状瘢痕患者。对所有患者，以正常猴视网膜为抗原底物，采用间接免疫荧光检测法测定血清ARA，以异硫氰酸荧光素（FITC）标记的山羊抗人IgA、G、M血清作为二抗。
所有患者血清中均存在ARA，滴度范围为1:40至1:5120。对照血清（n = 28，均为男性）在46.4%的病例中显示滴度为1:10至1:40的ARA。高血清滴度的ARA是双侧CNV以及一只眼有CNV且对侧眼有玻璃膜疣的AMD患者的特征。双侧盘状瘢痕患者血清中检测到低滴度的ARA。间接免疫荧光（IIF）显示患者血清对视网膜组织的反应性有八种组织学模式。血清ARA类型与黄斑病变活动度之间未发现相关性。
我们的初步观察表明，AMD患者血清中普遍存在各种ARA。因此，不能排除ARA参与AMD的发病机制或病情进展。
