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December 1997

Apoptosis in Patients With Posterior Uveitis

Author Affiliations

From the Laboratory of Immunology (Drs Chan, Li, and Nussenblatt and Ms Matteson) and Clinical Branch (Dr Whitcup), National Eye Institute, National Institutes of Health, Bethesda, Md.

Arch Ophthalmol. 1997;115(12):1559-1567. doi:10.1001/archopht.1997.01100160729010

Background:  Apoptosis plays a part in the pathogenesis of autoimmune diseases.

Objective:  To investigate the expression of apoptotic markers in the eyes of patients with uveitis.

Methods:  With the use of immunohistochemical and in situ apoptotic detection techniques, apoptotic molecules (Fas or Fas ligand [FasL]) and nuclear DNA fragmentation were examined in 8 enucleated eyes with Behçet's disease (1), sarcoidosis (1), subretinal fibrosis and uveitis (1), sympathetic ophthalmia (4), and the Vogt-Koyanagi-Harada syndrome (1); in 5 chorioretinal biopsy specimens with acute retinal necrosis (2), multifocal choroiditis (1), sarcoidosis (1), and subretinal fibrosis and uveitis (1); and in 3 normal control eyes.

Results:  Fas and FasL were constitutively expressed in the normal human retina, but they were expressed much less in the choroid. Increased expression of Fas and FasL was found in the retina, chorioretinal scar, and choroidal granulomas in uveitic eyes. However, Fas and FasL expression was absent in the biopsy specimens with acute retinal necrosis, and little Fas or FasL was noted on infiltrating lymphocytes. DNA fragmentation was also identified in eyes with chorioretinal scar and gliosis.

Conclusions:  Apoptosis occurs in uveitic eyes and may play a regulatory role in limiting ocular inflammation. In uveitic eyes, a dysregulation of the Fas-FasL apoptotic pathway may lead to gliosis and fibrosis.

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