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Sarah Liebezeit, Sabine Beck, Dominik Wolters, Julia Teister, Katrin Lorenz, Norbert Pfeiffer, Franz H Grus; Antigen-antibody interactions predict the classification and progression of glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3897. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
In glaucoma (GL), neurodegenerative processes in the optic nerve lead to reduced visual fields resulting in persistent blindness due to continuous functional loss. Beyond other factors, elevated intraocular pressure as well as a modified autoimmune response contribute to GL. However, the relation between different clinical stages in GL and the autoimmune response remains unclear. The aim of the study was to analyze the correlation between Mean Deviation (MD) classification of Humphrey perimeters and progression to characteristic antigen profiles in serum of patients.
For the analysis of antibody reactivities, sera of patients (n=182, blood samples within 90 days before or after perimetry) with statical perimetry of both eyes were used and subdivided in 4 groups: (1) no GL (MD ≥ 0, n=23), (2) early GL (MD -0,01 to ≥ -6, n=68), (3) moderate GL (MD -6.01 to ≥-12, n=48) and (4) advanced GL (MD <-12, n=43). Sera of patients were incubated on nitrocellulose-coated slides prespotted with antigens of interest. Occurring antigen-antibody-reactions were visualized with fluorescence labeled (Cy5) anti-human-IgG secondary antibodies. For progression analysis, patients with more than 3 visual field examinations in a minimal time frame of 3 years were selected (n=73) and regression analyses were performed for progression versus immunoreactivity levels.
Immunoreactivites against spectrin showed a significant reduction between early (21097 ± 9247 [U]) and advanced GL (15506 ± 8441 [U], p=0.04). Only males had significantly lower reactivities against alpha-adducin (ADD1) in advanced (7382 ± 5153 [U]) compared to moderate GL (14957 ± 11084 [U], p=0.04). The stronger the progression, the higher the immunoreactivities against mitogen-activated protein kinase 3 (MAPK3, p=0.01), the lower against Glutathione S-Transferase (GST, p=0.04) and Glyceraldehyde-3 phosphate dehydrogenase (GAPDH, p<0.05).
The Humphrey perimeter MD-score revealed spectrin for both sexes and alpha-adducin for males as specific antigen candidates for distinct classification of GL. Furthermore, antigen immunoreactivities can be used as indicator for strong progression in GL patients. In the future, antigen profile models might be a valuable tool for diagnosis of GL.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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