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:

Oxidative stress and antibacterial properties of a graphene oxide-cystamine nanohybrid

Nanda SS, An SS, Yi DK

International Journal of Nanomedicine 2015, 10:549-556

Published Date: 12 January 2015

Profile of ocriplasmin and its potential in the treatment of vitreomacular adhesion

Stefanini FR, Maia M, Falabella P, Pfister M, Niemeyer M, Kashani AH, Humayun MS, Koss MJ

Clinical Ophthalmology 2014, 8:847-856

Published Date: 6 May 2014

Matched case-control studies: a review of reported statistical methodology

Niven DJ, Berthiaume LR, Fick GH, Laupland KB

Clinical Epidemiology 2012, 4:99-110

Published Date: 27 April 2012

Cardio classics revisited – focus on the role of candesartan

Maria Leonarda De Rosa

Vascular Health and Risk Management 2010, 6:1047-1063

Published Date: 23 November 2010

Atherogenic dyslipidemia and diabetes mellitus: what’s new in the management arena?

Ajoy Kumar, Vibhuti Singh

Vascular Health and Risk Management 2010, 6:665-669

Published Date: 30 July 2010

Management of high-risk popliteal vascular blunt trauma: clinical experience with 62 cases

Ali Pourzand, Bassir A Fakhri, Ramin Azhough, et al

Vascular Health and Risk Management 2010, 6:613-618

Published Date: 14 July 2010

Surgical treatment of elephantiasis of the feet in congenital lymphedema to facilitate the use of a compression mechanism

José Maria Pereira de Godoy, Lina MO Azoubel, Maria de Fátima Guerreiro Godoy

International Journal of General Medicine 2010, 3:115-118

Published Date: 5 March 2010

Achieving lipid goals with rosuvastatin compared with simvastatin in high risk patients in real clinical practice: a randomized, open-label, parallel-group, multi-center study: the DISCOVERY-Beta study

Toivo Laks, Ester Keba, Mariann Leiner, Eero Merilind, Mall Petersen, et al

Vascular Health and Risk Management 2008, 4:1407-1416

Published Date: 28 September 2008

Early seizures in patients with acute stroke: Frequency, predictive factors, and effect on clinical outcome

Andrea Alberti, Maurizio Paciaroni, Valeria Caso, Michele Venti, Francesco Palmerini, Giancarlo Agnelli

Vascular Health and Risk Management 2008, 4:715-720

Published Date: 30 June 2008