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Anti-fumarase antibody promotes the dropout of photoreceptor inner and outer segments in diabetic macular oedema.

ABSTRACT: AIMS/HYPOTHESIS:In diabetic macular oedema (DMO), blood components passing through the disrupted blood-retinal barrier cause neuroinflammation, but the mechanism by which autoantibodies induce neuroglial dysfunction is unknown. The aim of this study was to identify a novel autoantibody and to evaluate its pathological effects on clinically relevant photoreceptor injuries. METHODS:Biochemical purification and subsequent peptide fingerprinting were applied to identify autoantigens. The titres of autoantibodies in DMO sera were quantified and their associations with clinical variables were evaluated. Two animal models (i.e. passive transfer of autoantibodies and active immunisation) were characterised with respect to autoimmune mechanisms underlying photoreceptor injuries. RESULTS:After screening serum IgG from individuals with DMO, fumarase, a Krebs cycle enzyme expressed in inner segments, was identified as an autoantigen. Serum levels of anti-fumarase IgG in participants with DMO were higher than those in diabetic participants without DMO (p?

SUBMITTER: Yoshitake S

PROVIDER: S-EPMC6441336 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Anti-fumarase antibody promotes the dropout of photoreceptor inner and outer segments in diabetic macular oedema.

Yoshitake Shin S Murakami Tomoaki T Suzuma Kiyoshi K Yoshitake Tatsuya T Uji Akihito A Morooka Satoshi S Dodo Yoko Y Fujimoto Masahiro M Shan Yang Y Fort Patrice E PE Ito Shinji S Tsujikawa Akitaka A Yoshimura Nagahisa N

Diabetologia 20181128 3

<h4>Aims/hypothesis</h4>In diabetic macular oedema (DMO), blood components passing through the disrupted blood-retinal barrier cause neuroinflammation, but the mechanism by which autoantibodies induce neuroglial dysfunction is unknown. The aim of this study was to identify a novel autoantibody and to evaluate its pathological effects on clinically relevant photoreceptor injuries.<h4>Methods</h4>Biochemical purification and subsequent peptide fingerprinting were applied to identify autoantigens. ...[more]

PMID: 30488085

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Project description:Importance:In diabetic macular edema (DME), identification of baseline markers on spectral-domain optical coherence tomography (SD-OCT) and their association with severity of diabetic retinopathy (DR) might aid in disease management and the design of future trials. Objective:To examine associations between DR severity, retinal morphology on SD-OCT, and visual acuity in participants with DME. Design, Setting, and Participants:This cross-sectional observational case series was conducted at a single tertiary care referral center. Demographics, visual acuity, SD-OCT, and color fundus photographs of 80 individuals with DME (102 eyes) seen between December 28, 2013, and April 30, 2014, were analyzed between May 1 and July 31, 2016. Main Outcomes and Measures:Features captured on SD-OCT and thickness metrics. On SD-OCT we graded type and shape of DME, shape and presence of septae within the intraretinal cystoid abnormalities, presence of hyperreflective dots and foci, integrity of the external limiting membrane and ellipsoid zone, presence and extent of disorganization of the inner retinal layers (DRIL), and the status of the vitreomacular interface and epiretinal membrane. We measured retinal thickness at the fovea and at the site of maximum pathology, choroidal thickness at the fovea, and 1000 ?m temporal and nasal to the fovea. Color photographs were graded to derive a DR severity stage. Results:The mean (SD) age was 63 (11) years, and 30 participants (37.5%) were women. The odds of having DRIL were greater in eyes with disrupted external limiting membrane (odds ratio [OR], 4.4; 95% CI, 1.6-12.0; P?=?.003), disrupted ellipsoid zone (OR, 2.7; 95% CI, 1.0-7.2; P?=?.03), presence of epiretinal membrane (OR, 2.8; 95% CI, 1.0-7.4; P?=?.03), and increase in retinal thickness at the fovea (OR, 1.6; 95% CI, 1.1-2.2; P?<?.001). Occurrence of DRIL was more likely in eyes with proliferative DR (OR, 7.3; 95% CI, 1.7-31.4; P?=?.007). Mean visual acuity decreased by approximately 4.7 letters for each 100-?m increase in the average global DRIL (95% CI, -7.9 to 1.4; P?=?.006). Conclusions and Relevance:An association was found between DRIL and disruption of the outer retina and increasing DR severity. Further longitudinal studies seem warranted to determine whether DRIL is a clinically relevant noninvasive morphological marker in eyes with DME.

Dataset Information

Anti-fumarase antibody promotes the dropout of photoreceptor inner and outer segments in diabetic macular oedema.

Publications

Anti-fumarase antibody promotes the dropout of photoreceptor inner and outer segments in diabetic macular oedema.

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