July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Agonistic β2-Adrenergic Receptor Autoantibodies:
Longitudinal analysis of the efficacy of beta-adrenoceptor antagonist on intraocular pressure
Author Affiliations & Notes
  • Bettina Hohberger
    Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany
  • Rudolf Kunze
    Max Delbrück Center for Molecular Medicine, Berlin, Germany
  • Gerd Wallukat
    Max Delbrück Center for Molecular Medicine, Berlin, Germany
  • Robert Lämmer
    Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany
  • Footnotes
    Commercial Relationships   Bettina Hohberger, None; Rudolf Kunze, EP 1832600 A1 (P); Gerd Wallukat, EP 1832600 A1 (P); Robert Lämmer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2720. doi:
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      Bettina Hohberger, Rudolf Kunze, Gerd Wallukat, Robert Lämmer; Agonistic β2-Adrenergic Receptor Autoantibodies:
      Longitudinal analysis of the efficacy of beta-adrenoceptor antagonist on intraocular pressure
      . Invest. Ophthalmol. Vis. Sci. 2018;59(9):2720.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Agonistic autoantibodies (AAB) against β2-adrenergic receptors (ß2-AR) have been described in glaucoma patients previously. Even, 69% of ocular hypertension (OHT) and 78% of primary open-angle glaucoma (POAG) patients showed these AABs against the ß2-AR. Because both, the ß2-AAB and the beta-adrenoceptor antagonists (e.g. timolol eye drops) recognize the same receptor, it is of interest, whether a local beta-blocker therapy shows a different efficacy considering AAB against ß2-AR positivity.

Methods : 134 eyes of 67 patients of the Erlangen Glaucoma Registry (EGR, ISSN 2191-5008, CS-2011; NTC00494923) were included: 64 OHT, 24 pre-perimetric POAG (pre-POAG) and 46 POAG. All patients underwent annually complete ophthalmological examinations including measurements of intraocular pressure (IOP) at 5 different times of the day (8.00 a.m., 12.00 a.m, 5.00 p.m., 9.00 p.m., 12.00 p.m.). Serum probes were analyzed of β2-AABs using a bioassay. Longitudinal analysis was done for both eyes with a follow-up of 25 years. Loss of efficacy was defined as further administration of additive or different anti-glaucomatous eye drops and/or anti-glaucomatous operations. The protocol was approved by the local Ethics Committee.

Results : (1) Forty-eight patients showed AAB against ß2-AR; 19 patients had no AABs against ß2-AR. (2) Fifty-five eyes of the AAB positive patients showed a loss of efficacy over the follow-up period (87.30%). (3) Efficacy of local beta-blocker therapy was lost in 16 of the eyes of AAB negative patients during 25 years follow-up (76.19%). (4) However, statistical significance between both groups was not reached (p=0.086).

Conclusions : As beta-adrenoceptor antagonists and AABs against ß2-AR focus on the same cellular target, a trend towards a decreased efficacy of beta-adrenoceptor antagonists in the presence of these AABs seemed to be observed, however statistical significance was not reached. Future studies could follow-up this observation in a larger patients’ group and investigate the molecular basis.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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