Autoimmune destruction of pericytes as the cause of diabetic retinopathy

Duncan D AdamsFaculty of Medicine, University of Otago, Dunedin, New ZealandAbstract: In diabetic retinopathy, collapse of the retinal vasculature is associated with loss of the pericytes. These are contractile cells that together with endothelial cells form the terminal arterioles of the retina. Th...

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Autor principal:	Duncan D Adams
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9408a053322b49869fd5cd5ee3b50093
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spelling	oai:doaj.org-article:9408a053322b49869fd5cd5ee3b500932021-12-02T09:17:14ZAutoimmune destruction of pericytes as the cause of diabetic retinopathy1177-54671177-5483https://doaj.org/article/9408a053322b49869fd5cd5ee3b500932008-06-01T00:00:00Zhttp://www.dovepress.com/autoimmune-destruction-of-pericytes-as-the-cause-of-diabetic-retinopat-a1783https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Duncan D AdamsFaculty of Medicine, University of Otago, Dunedin, New ZealandAbstract: In diabetic retinopathy, collapse of the retinal vasculature is associated with loss of the pericytes. These are contractile cells that together with endothelial cells form the terminal arterioles of the retina. The cause of the loss of pericytes is not known. Recently, it has been discovered that type 1 diabetes is caused by forbidden clones of cytotoxic T lymphocytes, which destroy the insulin-making cells with exquisite specificity. In the light of this, I postulate that an antigenically-related forbidden clone of cytotoxic T lymphocytes selectively destroys the pericytes and that this is the cause of the vascular collapse of diabetic retinopathy. If this is so, the therapeutic implications are immense, involving a switch from ineffectual tight glycemic control to immunotherapy. This is already used as immunosuppression to prevent organ transplant rejection, and as the immune ablation and autologous bone marrow cell reconstitution that has saved the lives of patients with lethally-severe scleroderma. Once the pericyte surface auto-antigen for the T lymphocytes has been isolated, selective destruction of the pathogenic T lymphocytes would be possible by manufacture and use of cytotoxic auto-antigen complexes, which arrests progression of the retinopathy.Keywords: pericytes, diabetic retinopathy, autoimmunity, T cell forbidden clones, immunotherapy Duncan D AdamsDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 2, Pp 295-298 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Duncan D Adams Autoimmune destruction of pericytes as the cause of diabetic retinopathy
description	Duncan D AdamsFaculty of Medicine, University of Otago, Dunedin, New ZealandAbstract: In diabetic retinopathy, collapse of the retinal vasculature is associated with loss of the pericytes. These are contractile cells that together with endothelial cells form the terminal arterioles of the retina. The cause of the loss of pericytes is not known. Recently, it has been discovered that type 1 diabetes is caused by forbidden clones of cytotoxic T lymphocytes, which destroy the insulin-making cells with exquisite specificity. In the light of this, I postulate that an antigenically-related forbidden clone of cytotoxic T lymphocytes selectively destroys the pericytes and that this is the cause of the vascular collapse of diabetic retinopathy. If this is so, the therapeutic implications are immense, involving a switch from ineffectual tight glycemic control to immunotherapy. This is already used as immunosuppression to prevent organ transplant rejection, and as the immune ablation and autologous bone marrow cell reconstitution that has saved the lives of patients with lethally-severe scleroderma. Once the pericyte surface auto-antigen for the T lymphocytes has been isolated, selective destruction of the pathogenic T lymphocytes would be possible by manufacture and use of cytotoxic auto-antigen complexes, which arrests progression of the retinopathy.Keywords: pericytes, diabetic retinopathy, autoimmunity, T cell forbidden clones, immunotherapy
format	article
author	Duncan D Adams
author_facet	Duncan D Adams
author_sort	Duncan D Adams
title	Autoimmune destruction of pericytes as the cause of diabetic retinopathy
title_short	Autoimmune destruction of pericytes as the cause of diabetic retinopathy
title_full	Autoimmune destruction of pericytes as the cause of diabetic retinopathy
title_fullStr	Autoimmune destruction of pericytes as the cause of diabetic retinopathy
title_full_unstemmed	Autoimmune destruction of pericytes as the cause of diabetic retinopathy
title_sort	autoimmune destruction of pericytes as the cause of diabetic retinopathy
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/9408a053322b49869fd5cd5ee3b50093
work_keys_str_mv	AT duncandadams autoimmunedestructionofpericytesasthecauseofdiabeticretinopathy
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Autoimmune destruction of pericytes as the cause of diabetic retinopathy

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