New PDF release: 2014-2015 Basic and Clinical Science Course (BCSC): Section

By American Academy of Ophthalmology, Ramana S. Moorthy MD

ISBN-10: 161525563X

ISBN-13: 9781615255634

Starts off with an summary of immune-mediated eye sickness, summarizing simple immunologic ideas, ocular immune responses and precise themes in ocular immunology. Discusses the scientific method of uveitis and stories noninfectious (autoimmune) and infectious types of uveitis, with an improved part on viral uveitis and new fabric on infectious and noninfectious scleritis.

Enhanced detection of infectious brokers through immunologic and genetic tools and biologic therapeutics are unique. additionally covers endophthalmitis, masquerade syndromes, problems of uveitis and ocular points of AIDS.

Upon final touch of part nine, readers could be capable to:

Identify normal and particular pathophysiologic tactics that impact the constitution and serve as of the uvea, lens, intraocular cavities, retina, and different tissues in acute and persistent intraocular inflammation
Differentiate and establish infectious and noninfectious uveitic entities
Choose acceptable exam recommendations and suitable ancillary reviews in keeping with even if an infectious or noninfectious reason is suspected

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Extra resources for 2014-2015 Basic and Clinical Science Course (BCSC): Section 9: Intraocular Inflammation and Uvetis

Sample text

Adherence of bacteria and leukocytes to the surface has also been implicated. Toxicity caused by contaminants on the lens surface during manufacturing has become rare. Nevertheless, even many noninflamed eyes with lOLs can demonstrate histologic evidence of low-grade foreign-body reactions around the haptics. Pepose JS, Holland GN, Wilhelmus KR, eds. Ocular Infection and Immunity. St Louis, MO: Mosby; 1996. 18 • lntraocular Inflammation and Uveitis • by the innate immune response occurs rapidly in a tightly controlled process requiring 2 main mechanisms: • neutrophil adhesion to the vascular endothelium through cell-adhesion molecules (CAMs) on leukocytes as well as on endothelial cells primarily in postcapillary venules • transmigration of the neutrophils through the endothelium and its extracellular matrix, mediated by chemotactic factors For resting neutrophils to escape from blood vessels, an essential adhesion with activated vascular endothelial cells must occur; this is triggered by various innate stimuli, such as LPS, physical injury, thrombin, histamine, or leukotriene release.

Cytokine interactions can be additive, combinatorial, synergistic, or antagonistic. Elimination of the action of a single molecule may have an unpredictable outcome; for example, monoclonal antibodies directed against tumor necrosis factor a (TNF-a) result in substantial suppression of immune responses but also increase susceptibility to multiple sclerosis. Finally, not only do innate and adaptive immune responses use cytokines as mediators and amplifiers of inflammation, but cytokines also modulate the initiation of immune responses; the function of most leukocytes is altered by preexposure to various cytokines.

The terms interleukin or lymphokine identify cytokines thought to mediate intercellular communication among lymphocytes or other leukocytes. Interferons are cytokines that limit or interfere with the ability of a virus to infect a cell; monokines are immunoregulatory cytokines secreted by monocytes and macrophages; and chemokines are chemotactic cytokines. Table 1-3 Cytokines of Relevance to Ocular Immunology Family - Interleukins - Example IL-la - IL-6 - Major Target Cells Major General Actions Macrophages Many others Most leukocytes Various ocular cells Many actions on T and B lymphocytes Systematic toxicity (fever, shock) Most leukocytes Various ocular cells Many actions on B lymphocytes Systematic toxicity (fever, shock) T lymphocytes B lymphocytes NK cells T lymphocytes B lymphocytes Activates CD4 and CDS T lymphocytes Induces Th1 Induces Th2, blocks Th1 Induces B lymphocytes to make lgE Macrophages T lymphocytes IL-2 IL-4 IL-5 Alpha chemokines IL-8 Beta chemokines Macrophage chemotactic protein-1 (MCP-1) TNF-a or-~ Tumor necrosis factors - Major Cell Source Mast cells Mast ocular epithelium ThO or Th1 CD4 T lymphocytes Th2 CD4 T lymphocytes Basophils, mast cells Th2 CD4 T lymphocytes Many cell types Macrophages Endothelium RPE Macrophages (TNF-a) T lymphocytes (TNF-~) Recruits eosinophils Endothelial cells Neutrophils Many others Endothelial cells Macrophages T lymphocytes Recruits and activates neutrophils Up-regulates CAM on endothelium Recruits and activates macrophages, some T lymphocytes Tumor apoptosis Macrophage and neutrophil activation Cell adhesion and chemotaxis Fibrin deposition and vascular injury Systemic toxicity (fever, shock) Specific Ocular Actions Altered vascular permeability Neutrophil and macrophage infiltration Langerhans migration to central cornea Altered vascular permeability Neutrophil infiltration High levels in many forms of uveitis and nonuveitic diseases .

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2014-2015 Basic and Clinical Science Course (BCSC): Section 9: Intraocular Inflammation and Uvetis by American Academy of Ophthalmology, Ramana S. Moorthy MD


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