Immunoregulatory Systems

A form of immune privilege, likely similar to ACAID, is present after subretinal injection of antigen. Iris, ciliary body, and RPE cells all contribute to immune homeostasis of the eye that is mediated by soluble or membrane-bound molecules. This observation may be important because of growing interest in retinal transplantation, stem cell therapies, and gene therapy. (See Clinical Example 3-2.) The RPE can limit activation of T cells and convert effector cells to regulatory cells. The capacity of the choriocapillaris and choroid to function as unique environments for the afferent or effector phases has not yet been evaluated.

• Lee RW, Nicholson LB, Sen HN, et al. Autoimmune and autoinflammatory mechanisms in uveitis. Semin Immunopathol. 2014;36(5):581–594.

• Mochizuki M, Sugita S, Kamoi K. Immunological homeostasis of the eye. Prog Retin Eye Res. 2013;33:10–27.

• Vogt SD, Barnum SR, Curcio CA, Read RW. Distribution of complement anaphylatoxin receptors and membrane-bound regulators in normal human retina. Exp Eye Res. 2006;83(4):834–840.

Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.