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Y. Hirami, M. Mandai, N. Kawagoe, T. Yokota, M. Takahashi, N. Yoshimura; A New Sensitive Approach to the Diagnosis of Autoimmune Retinopathy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5122.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Autoimmune retinopathy is caused by autoimmune reaction toward retinal specific antigens. The disease often presents similar clinical findings with retinitis pigmentosa, but these diseases should be differentially diagnosed because of their distinct pathological background, one with immunologic and the other, genetic. The goal of this study was to raise the sensitivity of diagnostic procedure for autoimmune retinopathy and to confirm the immunologic involvement in a patient whose diagnosis had been difficult with a currently popular western blotting method using whole retinal lysate. Methods:A 53 year old woman was suspected of autoimmune retinopathy from her disease course and clinical findings. To prove a possible immunologic involvement in her disease, the patient sera was tested by Western blot analysis using the lysate from human embryonic kidney cells overexpressing tagged recoverin and by ELISA using recombinant human recoverin protein. Peripheral blood mononuclear cells were also obtained from the patient to isolate her dendritic cells (DC) and T cells. Recoverin loaded DC was co–cultured with autologus T cells and the proliferated T cells were assayed for intracellular IFN–gamma production and CD107a surface expression under the antigen presentation by autologus DC. Results:The serum sample was positive for Western blot analysis and serum antibody titer against recoverin was significantly raised compared to normal serum. Intracellular IFN–gamma production as well as CD107a expression was increased in patient's T cells when pulsed with recoverin loaded DC. Conclusions:Our approach was sensitive enough to successfully diagnose autoimmune retinopathy in the patient who had not been diagnosed by general western method. Our approach may enable more patients with autoimmune retinopathy to be diagnosed. Our results also suggested that both Th1 and Th2 pathways may be involved in the disease process.
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