Year : 1983 | Volume
: 31 | Issue : 7 | Page : 906--908
Immunologic aspects of lens induced ocular reactions: Serum immunoglobulin profile
AK Gupta, R Saraf, GS Sarin
Guru Nanak Eye Centre and Maulana Azad Medical College New Delhi, India
A K Gupta
VI/6, Maulama Azad Medical College Campus, Kolta Road, New Delhi-110 002
|How to cite this article:|
Gupta A K, Saraf R, Sarin G S. Immunologic aspects of lens induced ocular reactions: Serum immunoglobulin profile.Indian J Ophthalmol 1983;31:906-908
|How to cite this URL:|
Gupta A K, Saraf R, Sarin G S. Immunologic aspects of lens induced ocular reactions: Serum immunoglobulin profile. Indian J Ophthalmol [serial online] 1983 [cited 2022 Jan 20 ];31:906-908
Available from: https://www.ijo.in/text.asp?1983/31/7/906/29702
Lens induced is an adjective coined to describe the sterile etiology of ocular malfunction or inflammation which are dependent on either the toxic or antigenic properties of cataractous, hypermature or degenerating lens proteins. The hypersensitivity concept is one of the theories put forth to explain the pathogenesis of lens induced ocular reactions. The main objective of the present report is to highlight the possibility of an antoimmune mechanism being involved in the disease entity. This study had been undertaken keeping the aforesaid aspect in view. The serum complement components profile (C-3, C-4 and C-5) and total hemolytic complement (CH-50) were studied.
MATERIAL AND METHODS
The study was conducted at Guru Nanak Eye Centre, New Delhi. Sixty eight subjects including 33 patients of lens induced ocular reactions and 35 healthy subjects were investigated. Patients with other ocular diseases, systemic disease, family or personal history of allergy were not included.
The diagnoses was established by clinical history and ocular examination including ophthalmoscopy and slit lamp biomicroscopy. The patients in this group were subdivided as follows:
(a) Phacotoxic uveitis 17 patients
(b) Phacolytic glaucoma 11 patient,,
(c) Endophthalmitis phaco- 5 patients anaphylactica
Quantitative estimation of serum complement components (C-3, C-4 and C-5) of all the patients and healthy subjects was done by single radial immuno-diffusion technique of Mancini et al. Total hemolytic complement was determined by the technique to Campbell
There were 28 males and 7 females in the control group of healthy subjects (mean age 40.8 years) and 24 males and 9 females in the patients with lens induced ocular reaction (mean age 57.1 years). The serum complement components and hemolytic complement in healthy subjects and in lens induced ocular reactions are given in [Table 1]. It is evident from the table that there is a significant fall in the C-3 and CH-50 levels and that there was a significant rise in the C-5 levels while the C-4 level remained unchanged when compared to the respective levels in healthy subjects. [Tables 2][Table 3][Table 4] show the levels of C-3, C-4, C-5 and CH-50 in phacotoxic uveitis, phacolytic glaucoma and endophthalmitis phacoanaphylactica respectively in comparison to normal healthy subjects. C-3 and CH-50 levels were found to be significantly low when compared to healthy subjects in all the three sub-groups. C-4 level was unaltered in these patients. However, C-5 level was significantly high in phacotoxic uveitis and endophthalmitis phacoanaphylactic while it was unaltered in phacolytic glaucoma.
There was a marked fall in the C-3 and CH50 levels and rise in the C-5 level in the lens induced ocular reactions. Previous studies show that in lens induced granulomatous endophthalmitis C-3 is present in injured lensesa. The cobra venom factor depletes C-3 and it also prevents the development of experimental lens-induced granulomatous endophthalmitia. These findings suggest that probably C-3 is used up in the induction of the disease and will thus explain the low C-3 level.
The total hemolytic complement (CH-50) level in serum was significantly low in all the patients when compared_ to the level in healthy subjects. The low level of CH-50 in the serum of patients of lens induced ocular reaction may be due to its excessive utilization. The depression of C-3 and CH-50 levels indicates the involvement of specific humoral immune mechanism. It seems plausible that there is auto-antibody formation. However the reason for auto-antibody formation is not clear but the possibility exists that lens matter may act as an antigen by itself or it may combine with a pathogen and rendered antigenic.
The present findings suggest that lens induced ocular reaction is possibly an immune phenomenon in which complement components are taking active part. This possibility is strongly confirmed by the high titre of C-5 level in response to an immunological reaction. C-3 is probably used up in the process of the reaction (calssic and/or alternate complement activation pathway).
Thirty three patients of lens induced ocular reactions comprising 17 patients of phacotoxic uveitis, 11 patients of phacolytic glaucoma and 5 patients of endophthalmitis phacoana phylactica were studied for complement components (C-3, C-4 and C-5) and total hemolytic complement (CH-50). Thirty five healthy subjects served as normal controls. C-3 level and CH-50 level were significantly low while C-5 level was significantly high and C-4 level was unaltered in lens induced ocular reactions patients. C-3 and CH-50 levels were found to be significantly low in all the three sub-groups. C-4 level was unchanged in the three subgroups. However, C-5 level was significantly high in phacotoxic uveitis and endophthalmitis phacoanaphylactica while it was unaltered in the sub-group of phacolytic glaucoma.
|1||Verhoeff F.H. and Lemoine A.N. 1922, Amer. J. Ophthalmol 5:737.|
|2||Mancini G. Carborara A.O. and Heremans J.F., 1965, Int. J. Immunochem 2:235.|
|3||Campbell D.H., Gervey J.S., Cremer N.E. and Sussdorf D.H., 1970, Methods in Immunology, 2nd Edition. Ed. Benjanim W.A., Inc. New York.|
|4||Marak G.E. Jr., 1978, Ophthal. Res. 10:30.|