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

Autoimmune destruction of pericytes as the cause of diabetic retinopathy

Authors Adams D

Published 6 June 2008 Volume 2008:2(2) Pages 295—298


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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 


Readers of this article also read:

Local sustained delivery of acetylsalicylic acid via hybrid stent with biodegradable nanofibers reduces adhesion of blood cells and promotes reendothelialization of the denuded artery

Lee CH, Lin YH, Chang SH, Tai CD, Liu SJ, Chu Y, Wang CJ, Hsu MY, Chang H, Chang GJ, Hung KC, Hsieh MJ, Lin FC, Hsieh IC, Wen MS, Huang Y

International Journal of Nanomedicine 2014, 9:311-326

Published Date: 6 January 2014

Pars plana vitrectomy for malignant glaucoma in nonglaucomatous and in filtered glaucomatous eyes

Matlach J, Slobodda J, Grehn F, Klink T

Clinical Ophthalmology 2012, 6:1959-1966

Published Date: 27 November 2012

Molecular markers of susceptibility to ocular toxoplasmosis, host and guest behaving badly

Adriana Lima Vallochi, Anna Carla Goldberg, Angela Falcai, Rajendranath Ramasawmy, Jorge Kalil, et al

Clinical Ophthalmology 2008, 2:837-848

Published Date: 5 December 2008

Latanoprost ophthalmic solution in the treatment of open angle glaucoma or raised intraocular pressure: a review

Andrea Russo, Ivano Riva, Teodoro Pizzolante, Federico Noto, Luciano Quaranta

Clinical Ophthalmology 2008, 2:897-905

Published Date: 5 December 2008

The prevalence rates of refractive errors among children, adolescents, and adults in Germany

Sandra Jobke, Erich Kasten, Christian Vorwerk

Clinical Ophthalmology 2008, 2:601-607

Published Date: 12 September 2008

Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy

J Charles Henry, James H Peace, Jeanette A Stewart, William C Stewart

Clinical Ophthalmology 2008, 2:613-621

Published Date: 12 September 2008

Efficacy and tolerability of a fixed-dose moxifloxacin – dexamethasone formulation for topical prophylaxis in LASIK: a comparative, double-masked clinical trial

Mauro Campos, Mariana Ávila, Anelise Wallau, Cristina Muccioli, Ana Luisa Höfling-Lima, Rubens Belfort Jr

Clinical Ophthalmology 2008, 2:331-338

Published Date: 6 June 2008

Can macular translocation be a satisfactory management of subfoveal choroidal neovascular membrane?

Árpád Bereczki, Zsolt Bíró

Clinical Ophthalmology 2008, 2:447-450

Published Date: 6 June 2008

Forgotten exogenous corticosteroid as a cause of central serous chorioretinopathy

Paul W Hardwig, Amila O Silva, Jose S Pulido

Clinical Ophthalmology 2008, 2:199-201

Published Date: 7 March 2008