Uveitis: Retinal Immune Cells Serve as Gatekeepers to the Central Nervous System

MedicalResearch.com Interview with:

Kip Connor, Ph.D.Harvard Medical SchoolAssociate Professor of Ophthalmology Department of OphthalmologyMassachusetts Eye and EarMGH ECOR Ophthalmology RepresentativeAssociate Scientist

Dr. Connor

Kip Connor, Ph.D.
Harvard Medical School
Associate Professor of Ophthalmology
Department of Ophthalmology
Massachusetts Eye and Ear
MGH ECOR Ophthalmology Representative
Associate Scientist

MedicalResearch.com: What is the background for this study?

Response: Classically, the retina and the central nervous system (CNS) have long been considered immunoprivileged sites within the body. This is not to say that these sites lack immunity; rather, they are capable of exhibiting a contained yet modifiable form of immunological response. Indeed, an intricate immune surveillance system exists within the retina that can interact with the retinal cellular milieu both during development and in response to injury or disease. While activation of this surveillance system can help protect and repair the delicate neural tissue of the retina in certain disease states, over-activation of this system can exacerbate disease pathology, thereby worsening vision loss.

Microglia are the resident immune cells of the central nervous system, including the retina, and are thought to function acutely in the homeostatic maintenance of the neuro-retinal microenvironment.  However in chronic conditions, like autoimmune uveitis, we hypothesized that microglia become neurodegenerative.

In our current study we show for the first time a role for microglia in directing the initiation of this autoimmune disease by orchestrating the inflammatory response within the retina through the retinal vessels.

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Effect of Adalimumab on Visual Functioning in Patients With Noninfectious Uveitis

MedicalResearch.com Interview with:
Andrew Dick FRSB FMedSci

Professor of Ophthalmology
Bristol Eye Hospital, University of Bristol, Bristol, England
National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, Institute of Ophthalmology, University College London, London, England and
John Sheppard, MD
President, Virginia Eye Consultants
Professor of Ophthalmology, Eastern Virginia Medical School

MedicalResearch.com: What should readers take away from your report?

Dr. Andrew Dick: These findings demonstrate that adalimumab is associated with clinically meaningful improvements in visual functioning for patients with non-infectious intermediate uveitis, posterior uveitis, and panuveitis. The emphasis of this work is that for the first time in uveitis we have seen patient reported outcome benefit of a biologic treatment. This analysis supports the use of adalimumab as a promising new treatment option, having demonstrated improvements in both clinical and visual functioning outcomes in patients with active and inactive uveitis.

Dr. John SheppardUveitis has a substantial effect on individuals’ physical, professional, psychological, avocational and social functioning in day-to-day life. Adalimumab, an anti-inflammatory drug that binds to tumor necrosis factor, was recently approved for the treatment of non-infectious intermediate uveitis, posterior uveitis, and panuveitis. It is the first systemic therapy specifically approved for uveitis.  The analyses in this study provide evidence that patients with noninfectious uveitis treated with adalimumab experience significant and clinically meaningful improvements in vision-related quality of life, compared with those who received placebo.

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