Abstract
AIMS—Administration of unfractionated retinal antigen(s) (retinal extract, RE) suppresses RE induced experimental autoimmune uveoretinitis (EAU) and offers a potential therapeutic alternative to non-specific immunosuppressive therapies for posterior uveitis and autoimmune diseases. S-Ag and interphotoreceptor retinoid binding protein (IRBP) are two major autoantigens within soluble RE. It was aimed to assess, firstly, as has previously been shown with S-Ag, if IRBP can induce intranasal tolerance and, secondly, the contribution of both these major autoantigens to tolerance induction by whole RE. METHODS—Animals were tolerised by intranasal administration with S-Ag or IRBP, either alone or in combination, or RE before immunisation with either IRBP or RE. Control animals were administered nasally either PBS or MBP. Daily clinical responses were recorded biomicroscopically and histological grades were obtained using a semiquantitative scoring system. Weekly serum antibody levels to retinal antigens were measured by ELISA and delayed hypersensitivity responses (DTH) were assessed by skin reactivity to intradermal inoculation with retinal or non-specific antigens. RESULTS—Microgram doses of IRBP successfully suppressed both clinically and histologically IRBP induced EAU. This suppression was accompanied by reduced antigen specific DTH reactivity but maintained T cell dependent (IgG2a) antibody responses. Furthermore, combined S-Ag and IRBP administration afforded equal suppression of RE induced EAU when compared with RE therapy alone. Suppression of RE induced EAU was not achieved with administration of a non-retinal specific autoantigen, MBP. Although individually, both S-Ag and IRBP suppressed RE induced EAU, whole RE was unable to protect against IRBP induced disease. CONCLUSIONS—Intranasal administration of IRBP suppressed IRBP induced EAU in the Lewis rat. S-Ag and IRBP are the major contributors to the tolerogenicity within RE, despite the known uveogenicity of other retinal antigens within RE and induction of tolerance was retinal antigen specific. Furthermore, suppression induced by single antigen administration is antigen specific although concomitant bystander suppression may also play a role. RE was unable to protect against IRBP induced disease despite tolerogenic levels of antigen within RE. Although this may be due in part to a dose effect of either tolerising or immunising antigen, further investigation into the possible antigen dominance of IRBP or mucosal processing of combinations of antigens is necessary so that the full efficacy of mucosal tolerance therapy can be assessed.
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Figure 1 .
Antibody production in IRBP induced EAU in both controls and intranasal tolerised animals. There was no significant difference in total antibody levels (measured spectrophotometrically at OD490) except the group tolerised with retinal extract (RE) which had elevated total antibody titres (*p<0.05) on day 7. The increased antibody titre was predominantly IgG2a isotype. In the other groups antibody isotypes were also measured (IgM, IgG2a, and IgG1) and there was again no difference between the two groups with IgG2a generating the predominant antibody response (data not shown).
Figure 2 .
Delayed hypersensitivity reactivity (DTH) to retinal extract in both controls and IRBP tolerised animals in IRBP induced EAU. There was a significant reduction in DTH reactivity to retinal extract (p<0.05 at 24 hours) in animals tolerised with IRBP. This effect appears to be retinal antigen specific as reactivity to a non-specific protein, PPD, present in complete Freund's adjuvant within the immunising cocktail was equal in both groups (data not shown).
Figure 3 .
Administration of both S-Ag and IRBP intranasally protects against ROS damage in re-induced EAU. (A) Normal retinal morphology. V = vitreous, R = outer segments of rod photoreceptor cells (ROS). IRBP induced EAU results in a total loss of ROS (B, R) and destruction of both nuclear and ganglion cell layers of the retina (B, arrows). These animals also demonstrated fibrovascular membrane formation (arrowhead) as a result of intraocular inflammation. Administration of both tolerising doses of IRBP and S-Ag intranasally before immunisation with RE protects the ROS (C, R) although mononuclear leucocytic infiltration still occurs (C, arrow). The histological features are similar to the protection achieved with RE intranasal administration.
Selected References
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