Immunomodulation of experimental autoimmune uveitis using a rat anti retinal S-antigen specific monoclonal antibody: evidence for a species difference

Immunomodulation of experimental autoimmune uveoretinitis: a model of tolerance induction with retinal antigens

Experimental autoimmune uveoretinitis (EAU) is a CD4+ T-lymphocyte mediated inflammation of the uveal tract and retina. As a model of human posterior uveitis it permits further understanding of the underlying immunopathogenesis of uveitis. It also allows for preclinical trials of immunosuppressive therapies and in vivo assessment of alternative strategies for immunointervention. This review highlights possible immunostrategic modalities which prevent the initiation or perpetuation of the immune response, and in particular reports on the novel effect of intranasal induction of tolerance with retinal antigens, prior to immunisation with retinal antigens. The mechanisms and potential application of this 'natural' method of immunosuppression in the treatment of autoimmune disease are discussed.

Experimental autoimmune pinealitis in the rat: ultrastructure and quantitative immunocytochemical characterization of mononuclear infiltrate and MHC class II expression

Lewis rats immunized with Peptide M (an oligopeptide epitope of the S-antigen protein) developed experimental autoimmune uveoretinitis (EAU) and experimental autoimmune pinealitis (EAP). Temporal changes in mononuclear infiltrate to the pineal gland were quantitated by computer image analysis of sections immunostained with monoclonal antibodies to specific mononuclear populations. T helper/inducer cells (W3/25+) and monocyte/macrophages (OX-42+) were elevated during the early phases of inflammation (day 15) while cytotoxic/suppressor T cells (OX-8+) were elevated at days 15 and 21. Expression of MHC class II (OX-6) was markedly enhanced on pineal glia, but was not present on vascular endothelia during EAP. Ultrastructurally, many capillaries exhibited thickenings of the endothelia and basal lamina. EAP had little effect on the fine structure of pinealocytes and glia and there was little evidence of cellular destruction by day 21, in contrast to the extensive retinal destruction resulting from EAU. These findings suggest fundamental differences between EAU and EAP related to mechanisms of antigen processing/recognition in autoimmune diseases. Our study further indicates the importance of EAP as a model to investigate neuroendocrine-immune interactions.

Experimental autoimmune uveoretinitis: a model system for immunointervention: a review

Experimental autoimmune uveoretinitis (EAU) is a useful model of human posterior uveitis and as such, permits the analysis of strategies for immuno-intervention. Modulation of the autoimmune response may be attempted at the stages of induction of EAU, during homing of autoreactive lymphocytes to the target organ, the retina, or during the effector stage of the disease. This paper presents a brief overview of current immuno-therapeutic modalities and assesses the usefulness for extrapolation to human disease.

Inhibition of experimental autoimmune uveitis by retinal photoreceptor antigens coupled to spleen cells

Experimental autoimmune uveitis (EAU) and experimental autoimmune pinealitis (EAP) are CD4+ T cell-mediated inflammatory diseases of the uveal tract and retina of the eye and of the pineal gland. EAU and EAP can be induced by several retinal autoantigens including S-antigen (S-Ag) and interphotoreceptor retinoid binding protein (IRBP). In this study we investigated the effect of intravenous administration of S-Ag and IRBP coupled to syngeneic spleen cells on the development of EAU and EAP. Injection of S-Ag or IRBP coupled to spleen cells 5 days prior to immunization with native S-Ag or IRBP, respectively, was effective in preventing the induction of EAU and EAP in LEW rats. Conversely, LEW rats receiving S-Ag-coupled spleen cells and challenged with IRBP or LEW rats receiving IRBP-coupled spleen cells and challenged with S-Ag developed a severe EAU within 10 days to 2 weeks following immunization, as did all control animals receiving sham-coupled spleen cells and challenged with the two retinal antigens. The results show that the administration of retinal autoantigens coupled to spleen cells effectively protects against the development of EAU when animals are subsequently challenged with the tolerizing antigen but not when challenged with another unrelated pathogenic retinal autoantigen.

Epitopes and idiotypes in experimental autoimmune uveitis: a review

Retinal S-antigen (SAg) and interphotoreceptor retinol-binding protein (IRBP) induced experimental autoimmune uveitis (EAU) and experimental autoimmune pinealitis (EAP) are good models for studying the mechanisms involved in autoimmune diseases. Many immunogenetically active epitopes have been identified in these proteins but immunodominance of one or more epitopes in vivo, has not yet been established. In this paper we present and discuss some experiments that led to the discovery of a dominant "tolerogenic" epitope in SAg. We also demonstrate the presence of cross reactive epitopes in the two potent retinal antigens, SAg and IRBP and finally introduce early data on a unique anti S2.4.c5 idiotypic (Id) monoclonal antibody (MAb) which appears to be a site non associated antibody that binds not only to s2.4.c5 but also to SAg.

Ultrastructural pathology of the 'barrier sites' in experimental autoimmune uveitis and experimental autoimmune pinealitis

Lewis rats were immunised with retinal S-antigen to induce experimental autoimmune uveitis and experimental autoimmune pinealitis. The blood-retinal and blood-pineal 'barrier sites' were examined by transmission electron microscopy. Inflammatory cell movement through Bruch's membrane involved separation of its constituent layers, cell migration through pores in the membrane, and between retinal pigment epithelial cells without causing significant displacement of the retinal pigment epithelial cell layer. The endothelial cells of retinal and pineal vessels with perivascular infiltrates showed morphological features resembling endothelium of 'high endothelial venules'.

Structure-function studies of S-antigen: use of proteases to reveal a dominant uveitogenic site

Retinal S-antigen induced experimental autoimmune uveitis (EAU) is a severe, predominantly T-cell mediated inflammatory disease of the uveal tract and retina of the eye. Pretreatment of LEW rats with the monoclonal antibody, MAbS2.4.C5, which defines an epitope in S-antigen, has been shown to effectively inhibit the subsequent induction of EAU with S-antigen. Using synthetic peptides and cyanogen bromide fragments of S-antigen we found the binding site of MAbS2.4.C5 to be located at the carboxy terminus of the molecule corresponding to amino acid positions 375 to 380. Limited Staphylococcus aureus V8 protease digestion yielded several polypeptide fragments including one large 43 kD fragment which retained antibody binding to a variety of both polyclonal and monoclonal antibodies which identify epitopes that span the length of the S-antigen. This treatment, however, completely destroys the MAbS2.4.C5 binding site and dramatically reduces uveitopathogenicity. Limited trypsin and papain digestion, on the other hand, had little effect on pathogenicity or on MAbS2.4.C5 binding to S-antigen or its peptide fragments. These results indicate that the carboxy-terminus of S-antigen plays a predominant role in the pathogenesis of EAU.

Regulation of the local immune response by retinal cells

Experimental autoimmune uveoretinitis (EAU) induced by retinal antigens is a CD4+ (Th) lymphocyte mediated disease. Generation of autoreactive CD4+ cells requires the processing and presentation of autoantigen by antigen presenting cells (APC) in combination with MHC Class II antigen. Efficient presentation of antigen to T cells has also been shown to depend on accessory molecules of adhesion such as intercellular adhesion molecule-1 (ICAM-1) and leukocyte function-associated antigen-1 (LFA-1). Aberrant expression of Class II antigens by local tissue cells has been suggested as a possible mechanism in autoimmune processes. Several ocular cells express Class II antigens during inflammation, while other cells such as Muller cells inhibit antigen presentation in vitro. We have also shown that retinal pigment epithelial cells (constitutively) and endothelial cells (after induction) express ICAM-1 and that CD4+ lymphocyte adhesion to these cells is inhibited by antibodies to ICAM-1. Accessory molecules may therefore be important, not only in local presentation of antigen but in recruitment of circulating autoreactive cells to the eye since these cells represent the site of the blood-retinal barrier. Regulation of the local immune response in the eye therefore, may occur at several levels.

Regulation of retinal autoimmunity via the idiotypic network

The immune response to self antigens is regulated through an interplay of idiotypes and anti-idiotypes expressed on antibodies and lymphoid cells. The equilibrium of the different components of the immune system has been modulated in various autoimmune diseases by manipulation of the idiotypic network. Experimental autoimmune uveoretinitis (EAU) was induced in rats with one foot pad injection of S-antigen (S-Ag) in complete Freund's adjuvant (CFA). 1. Injection of rats with the mouse anti-S-Ag monoclonal antibody (mAb) S2D2 either simultaneously with or before S-Ag challenge, led to an anti-idiotypic (anti-Id) response and to inhibition of EAU. 2. Suppression of the disease could be passively transferred using lymph node and/or spleen cells from donors immunized with S2D2 to naive recipients, prior to immunization with bovine S-Ag in CFA. In contrast, one injection of IgG from S2D2-immunized rats did not prevent EAU. 3. Preimmunization against a purified rat polyclonal anti-Id-S2D2 antibody (internal image of the epitope recognized by mAb S2D2) before S-Ag challenge also allowed to inhibit EAU. As S2D2 was the best of several anti-S-Ag mAbs tested for disease inhibition, the epitope recognized by S2D2 should be of particular interest in the regulation of the immune response. This epitope has been localized to the N-terminal region of S-Ag, in the amino acid sequence 40-50. The S2D2 epitope is distant from all presently known uveitogenic sites. Manipulation of the idiotypic network for selected epitopes of the autoantigen may provide a valuable approach to therapy of autoimmune disease.