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-Enolase Found in Glaucoma Patients
From the Departments of Ophthalmology, Sapporo Medical University School of Medicine, Japan.
PURPOSE. To study pathologic roles of the presence of serum autoantibodies against retinal ganglion cells in patients with glaucoma.
METHODS. Serum autoantibody reactions were detected by Western blot analysis using retinal soluble fractions in 79 patients with glaucoma (normal-tension glaucoma [NTG], 23 cases; primary open-angle glaucoma [POAG], 56 cases) and 60 age-matched healthy subjects. Clinical characteristics including visual acuity, visual field, intraocular pressure (IOP), and optic disc features were compared between the serum autoantibodypositive and negative patients. The retinal autoantigen recognized by patients sera was identified by a combination of in-gel digestion and Edman sequencing.
RESULTS. Western blot analysis revealed that serum autoantibody against retinal
50-kDa antigen was recognized in 20 out of 79 glaucoma patients
(25.3%; 14 POAG and 6 NTG patients) and 60 age-matched control
subjects (11.7%), respectively. Immunocytochemistry revealed that
labeling of the ganglion cell layer (GCL) by IgG from glaucoma patients
(POAG: 13/56, 23.2%; NTG: 6/23, 26%) existed at a significantly
higher rate than that by IgG from control subjects (2/60, 3.3%;
P < 0.05). In POAG, maximum IOP in the serum
antibody positivepatients was significantly lower than that in the
antibody-negative patients (P < 0.05). However, no
statistical differences were observed in visual field loss, disc
cupping, and other clinical factors between the antibody-positive and
-negative groups in POAG and NTG. In-gel digestion of the 50-kDa band
in two-dimensional polyacrylamide gels and Edman sequence analysis of
the high-performance liquid chromatographypurified peptides
identified the 50-kDa protein as
-enolase. Injection of the 50-kDa
IgG from glaucoma patients or anti-
-enolase serum into the vitreous
cavity of Lewis rats caused reduction of the b-wave of the
electroretinogram and TdT-dUTP terminal nick-end labeling
(TUNEL)positive staining within the GCL.
CONCLUSIONS. In the current study, serum autoantibody against 50-kDa protein
identified as
-enolase in 25% of glaucoma
patients.
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