Back to Browse Journals » Clinical Ophthalmology » Volume 2 » Issue 2

Autoimmune destruction of pericytes as the cause of diabetic retinopathy

Authors Duncan D Adams

Published Date June 2008 Volume 2008:2(2) Pages 295—298

DOI http://dx.doi.org/10.2147/OPTH.S2629

Published 30 June 2008

Duncan D Adams

Faculty of Medicine, University of Otago, Dunedin, New Zealand

Abstract: In diabetic retinopathy, collapse of the retinal vasculature is associated with loss of the pericytes. These are contractile cells that together with endothelial cells form the terminal arterioles of the retina. The cause of the loss of pericytes is not known. Recently, it has been discovered that type 1 diabetes is caused by forbidden clones of cytotoxic T lymphocytes, which destroy the insulin-making cells with exquisite specificity. In the light of this, I postulate that an antigenically-related forbidden clone of cytotoxic T lymphocytes selectively destroys the pericytes and that this is the cause of the vascular collapse of diabetic retinopathy. If this is so, the therapeutic implications are immense, involving a switch from ineffectual tight glycemic control to immunotherapy. This is already used as immunosuppression to prevent organ transplant rejection, and as the immune ablation and autologous bone marrow cell reconstitution that has saved the lives of patients with lethally-severe scleroderma. Once the pericyte surface auto-antigen for the T lymphocytes has been isolated, selective destruction of the pathogenic T lymphocytes would be possible by manufacture and use of cytotoxic auto-antigen complexes, which arrests progression of the retinopathy.

Keywords: pericytes, diabetic retinopathy, autoimmunity, T cell forbidden clones, immunotherapy

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

Takahiro Ueno, Hironori Tsuchiya, Maki Mizogami, Ko Takakura

Journal of Inflammation Research 2008, 1:41-48

Published Date: 13 November 2008

Progress in antiretroviral drug delivery using nanotechnology

Rama Mallipeddi, Lisa Cencia Rohan

International Journal of Nanomedicine 2010, 5:533-547

Published Date: 22 July 2010

Neurotransmitter testing of the urine: a comprehensive analysis

Marty Hinz, Alvin Stein, George Trachte, et al

Research and Reports in Urology 2010, 2:177-183

Published Date: 7 October 2010

Amino acid-responsive Crohn's disease: a case study

Alvin Stein, Marty Hinz, Thomas Uncini

Clinical and Experimental Gastroenterology 2010, 3:171-177

Published Date: 6 December 2010

Fungus-mediated biological synthesis of gold nanoparticles: potential in detection of liver cancer

Chauhan A, Zubair S, Tufail S, Sherwani A, Sajid M, Raman SC, Azam A, Owais M

International Journal of Nanomedicine 2011, 6:2305-2319

Published Date: 12 October 2011

Insight into 144 patients with ocular vascular events during VEGF antagonist injections

Mansour AM, Shahin M, Kofoed PK, Parodi MB, Shami M, Schwartz SG

Clinical Ophthalmology 2012, 6:343-363

Published Date: 6 March 2012

Outcome mapping for health system integration

Tsasis P, Evans JM, Forrest D, Jones RK

Journal of Multidisciplinary Healthcare 2013, 6:99-107

Published Date: 14 March 2013

Nanostructured polyurethane-poly-lactic- co-glycolic acid scaffolds increase bladder tissue regeneration: an in vivo study

Yao C, Hedrick M, Pareek G, Renzulli J, Haleblian G, Webster TJ

International Journal of Nanomedicine 2013, 8:3285-3296

Published Date: 28 August 2013