Purpose
Age-related macular degeneration (AMD) is the leading cause of central vision loss in older adults. While individuals with AMD do not have clear signs of ocular inflammation, there is increasing evidence for autoimmune involvement. The goal of the study was to determine the AAb specificity associated with different AMD stages.
Methods
Sera of 134 participants in the Age-related Eye Disease Study were analyzed for anti-retinal AAbs by western blotting using human retinal proteins. The subjects represented: controls (N=26); large drusen (N=41); geographic atrophy (GA, N=28); neovascular AMD (N=33); and both - neovascular and GA (N=6).
Results
The presence of anti-retinal AAb was detected in 58.2% of patients with AMD and 53.8% of controls. Serum AAbs bound to fifteen different retinal antigens. Most individuals had singular specificity AAbs (68.8%), with the remainder having 2 to 4 different AAbs. The presence of AAbs declined in advanced stages of AMD. Anti-enolase AAbs occurred in 40% of patients with large drusen, and 46% of those with GA, compared with 29% of neovascular AMD and controls. Different AAbs signatures related to neovascular AMD (“wet”) as compared to GA (“dry”) and large drusen were distinguished. Anti-40-kDa and anti-42-kDa autoantibodies were associated with large drusen, while anti-30-kDa AAbs were primarily present in GA. AAbs against 32-kDa, 35-kDa, and 60-kDa proteins were more prevalent in neovascular AMD.
Conclusions
Decrease in AAbs presence in advanced stages of AMD and differences in frequencies of specific AAbs between AMD subgroups suggest that anti-retinal AAbs may participate in pathogenicity of AMD.
Keywords: 412 age-related macular degeneration •
432 autoimmune disease •
557 inflammation