Skip to main content
SpringerLink
Log in

Immune Therapy for Autoimmune Uveitis

  • Chapter
Immunopharmacology in Autoimmune Diseases and Transplantation

  • 51 Accesses

Abstract

Intraocular inflammatory disease (uveitis) presents an ongoing challenge to ophthalmologists dealing with this problem. The term “uveitis” has been used since the last century, since it was felt that the problem stemmed from an inflammation of uvea. Today, it is clear that this limited definition is not the case, and the term denotes any intraocular inflammatory disease, no matter what the cause and no matter what portion of the eye is affected by the disorder. Ocular inflammation is commonly dealt with by all ophthalmologists, either as a primary or secondary problem. It is the cause of about 10% of the severe visual handicap in the United States and Great Britain (U.S. DHEW., 1976). The diseases that fall under the umbrella term “uveitis” generally strike children and young adults, and thus often have a major impact on the family structure. The disorders are grouped as to those affecting the anterior and posterior portions of the globe. The International Uveitis Study Group, made up of 26 ophthalmologists currently representing many nations, has developed guidelines for the classification of uveitis. The disease entities are divided into three broad categories: anterior uveitis, intermediate uveitis, and posterior uveitis. This simplified system permits a standardized system for the classification of these disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Anderson, H. J., Churchill-Davidson, H. C., and Richardson, A. T., 1953, Bronchial neoplasm with myasthenia prolonged apnoea after administration of succinylcholine, Lancet 2:1291–1293.

    Article  Google Scholar 

  • Bennett, W. M., and Pulliam, S. P., 1983, Cyclosporine nephrotoxicity, Ann. Intern. Med. 99:851–854.

    Article  PubMed  CAS  Google Scholar 

  • Besinger, K. A., Toyka, K. V, Heininger, K., Fateh-Moghadan, A., Schumm, A., Sandel, P., and Birnberger, K. L., 1981, Longterm correlation of clinical course and acetylcholine receptor antibody in patients with myasthenia gravis, Ann. NY Acad. Sci. 377:812–815.

    Article  Google Scholar 

  • Blalock, A., Mason, M. E., Morgan, H. J., and Riven, S. S., 1939, Myasthenia gravis and tumors of the thymic region. Report of a case in which the tumor was removed, Ann. Surg. 110:544–560.

    Article  PubMed  CAS  Google Scholar 

  • Borel, J. E., Feurer, C., Nagnee, C., and Stahelin, H., 1977, Effects of the new antilymphotic peptide cyclosporin A in animals, Immunology 32:1017–1027.

    PubMed  CAS  Google Scholar 

  • Burges, J., Wray, D. W., Pizzighella, S., Hall, Z., and Vincent, A., 1990, A myasthenia gravis plasma immunoglobin reduces miniature endplate potentials at human endplates in vitro, Muscle Nerve 13:407–413.

    Article  PubMed  CAS  Google Scholar 

  • Carlsson, B., Wallin, J., Pirskanen, R., Matell, G., and Smith, C. I., 1990. Different HLA DR-DQ associations in subgroups of idiopathic myasthenia gravis, Immunogenetics 31:285–290.

    Article  PubMed  CAS  Google Scholar 

  • Compston, D. A. S., Vincent, A., Newsom-Davis, J., and Batchelor, J. R., 1980, Clinical, pathological, HLA antigen and immunological evidence for disease heterogeneity in myasthenia gravis, Brain 103:579–601.

    Article  PubMed  CAS  Google Scholar 

  • Connor, R. I., Lefvert, A. K., Benes, S. C., and Lang, R. W., 1990, Incidence and reactivity patterns of skeletal and heart (SH) reactive autoantibodies in the sera of patients with myasthenia gravis, J. Neuroimmunol. 26:147–157.

    Article  PubMed  CAS  Google Scholar 

  • Elmqvist, D., and Lambert, E. H., 1968, Detailed analysis of neuromuscular transmission in a patient with the myasthenie syndrome sometimes associated with bronchogenic carcinoma, Mayo Clin. Proc. 43:689–713.

    PubMed  CAS  Google Scholar 

  • Engel, A. G., 1986a, Acquired autoimmune myasthenia gravis, in: Myology. Basic and Clinical (A. G. Engel and B. Q. Banker, eds.), McGraw-Hill Book Company, New York, pp. 1925–1954.

    Google Scholar 

  • Engel, A. G., 1986b, Myasthenie syndromes, in: Myology. Basic and Clinical (A. G. Engel and B. Q. Banker, eds.), McGraw-Hill Book Company, New York, pp. 1955–1990.

    Google Scholar 

  • Engel, A. G., Lambert, E. H., and Howard, F. M., 1977, Immune complexes (IgG and C3) at the motor end-plate in mysthenia gravis. Ultrastructural and light microscopic localization and electrophysiological correlations, Mayo Clin. Proc. 52:267–280.

    PubMed  CAS  Google Scholar 

  • Erb, W., 1879, Zur Casuistik der bulbaren Lahmungen. 3 über einen neuen, wahrscheinlich bulbaren Symptomencomplex, Arch. Psychiatr. Nervenkr. 9:336–350.

    Google Scholar 

  • Fukunaga, H., Engel, A. G., Osame, M., and Lambert, E. H., 1982, Paucity and disorganization of presynaptic membrane active zones in the Lambert-Eaton myasthenie syndrome, Muscle Nerve 5:686–697.

    Article  Google Scholar 

  • Fukuoka, T., Engel, A, G., Lang, B., Newsom-Davis, J., and Vincent, A., 1987, Lambert-Eaton myasthenie syndrome: II. Immunoelectron microscopy localization of IgG at the mouse motor end-plate, Ann. Neurol 22:200–211.

    Article  PubMed  CAS  Google Scholar 

  • Guthrie, L. G., 1903, Myasthenia gravis in the seventeenth century, Lancet 1:330–331.

    Article  Google Scholar 

  • Gutmann, L., Crosby, T. W., Takamori, M., and Martin, J. D., 1972, The Eaton-Lambert syndrome and autoimmune disorders, Am. J. Med. 53:354–356.

    Article  PubMed  CAS  Google Scholar 

  • Jenkyn, L. R., Brooks, P. L., Forcier, R. J., Maurer, L. H., and Ochoa, J., 1980, Remission of the Lambert-Eaton syndrome and small cell anaplastic carcinoma of the lung induced by chemotherapy and radiotherapy, Cancer 46:1123–1127.

    Article  PubMed  CAS  Google Scholar 

  • Jolly, E., 1895, Uber Myasthenia gravis pseudoparalytica, Berl Klin. Wochenschr. 32:1–7.

    Google Scholar 

  • Komiya, T., and Sato, T., 1988, Long-term follow-up study of relapse in symptoms and reelevation of acetylcholine receptor antibody titers in patients with myasthenia gravis, Ann. NY Acad. Sci. 540:605–607.

    Article  PubMed  CAS  Google Scholar 

  • Lambert, E. H., and Elmqvist, D, 1971, Quantal components of end-plate potentials in the myasthenie syndrome, Ann. NY Acad. Sci. 183:183–199.

    Article  PubMed  CAS  Google Scholar 

  • Lambert, E. H., Eaton, L. M., and Rooke, E. D., 1956, Defect of neuromuscular conduction associated with malignant neoplasms, Am. J. Physiol 187:612–613.

    Google Scholar 

  • Lambert, E. H., Rooke, E. D, Eaton, L. M., and Hodgson, C. H., 1961, Myasthenie syndrome occasionally associated with bronchial neoplasm: Neurophysiologic studies, in: Myasthenia Gravis (H. R. Viets, ed.), C.C. Thomas, Springfield, 111, pp. 362–410.

    Google Scholar 

  • Lang, B., Newsom-Davis, J., Wray, D., Vincent, A., and Murray, N., 1981, Autoimmune aetiology for myasthenie (Eaton-Lambert) syndrome, Lancet 2:224–226.

    Article  PubMed  CAS  Google Scholar 

  • Lang, B., Newsom-Davis, J., Prior, C., and Wray, D., 1983, Antibodies to motor nerve terminals: An electrophysiological study of a human myasthenic syndrome transferred to mouse, J. Physiol (Lond.) 344:335–345.

    CAS  Google Scholar 

  • Lang, B., Newsom-Davis, J., Peers, C., Prior, C., and Wray, D., 1987, The effect of myasthenie syndrome antibody on presynaptic calcium channels in the mouse, J. Physiol 390:257–270.

    PubMed  CAS  Google Scholar 

  • Lefvert, A. K., 1981, The human acetylcholine receptor antibody: Studies of kinetic properties and the reaction with antiidiotypic antibodies, Ann. NY Acad. Sci. 377:125–141.

    Article  PubMed  CAS  Google Scholar 

  • Leys, K., Lang, B., Wincent, A., and Newsom-Davis, J., 1989, Calcium channel autoantibodies in Lambert-Eaton myasthenic syndrome, Lancet 2:1107.

    Article  PubMed  CAS  Google Scholar 

  • Limburg, P. C., The, H., Hummer-Tappel, E., and Oosterhuis, H. J. G. H., 1983, Anti acetylcholine receptor antibodies in myasthenia gravis. I. Their relation to the clinical state and the effect of therapy, J. Neurol. Sci. 58:357–370.

    Article  PubMed  CAS  Google Scholar 

  • Lindstrøm, J. M., Seybold, M. E., Lennon, V. A., Whittingham, S., and Duane, D. D., 1976, Antibody to acetylcholine receptor in myasthenia gravis, Neurobgy 26:1054–1059.

    Google Scholar 

  • McCarthy, M. P., Earnest, J. P., Young, E. F., Choe, S., and Stroud, R. M., 1986, The molecular neurobiology of the acetylcholine receptor, Annu. Rev. Neurosd. 9:383–413.

    Article  CAS  Google Scholar 

  • McEvoy, K. M., Windebank, A. J., Daube, J. R., and Low, P. A., 1989, 3,4-Diaminopyridine in the treatment of Lambert-Eaton myasthenie syndrome, N. Eng. J. Med. 321:1567–1571.

    Article  CAS  Google Scholar 

  • Mclntosh, K., and Drachman, D. B., 1984, Suppressor-cell immunotherapy of experimental autoimmune myasthenia gravis, Ann. Neurol 16:113.

    Google Scholar 

  • Mertens, H. G., Hertel, G., Reuther, P., and Ricker, K., 1981, Effect of immunosuppressive drugs (azathioprine), Ann. NY Acad. Sci. 377:691–699.

    Article  PubMed  CAS  Google Scholar 

  • Muraguchi, A., Butler, J. L., Kehrl, J. H., Falkoff, R. J. M., and Fauci, A. S., 1983, Selective suppression of an early step in human B cell activation by cyclosporin A, J. Exp. Med. 158:690–702.

    Article  PubMed  CAS  Google Scholar 

  • Newsom-Davis, J., and Murray, N. M. E., 1984, Plasma exchange and immunosuppressive drug treatment in the Lambert-Eaton myasthenie syndrome, Neurobgy 34:480–485.

    CAS  Google Scholar 

  • Nyberg-Hansen, R., and Gjerstad, L., 1985, Ciclosporin in the treatment of myasthenia gravis: Preliminary results from a pilot study, in: Ciclosporin in Autoimmune Diseases (A. Schindler, ed.), Springer Verlag, Berlin, pp. 96–99.

    Chapter  Google Scholar 

  • Nyberg-Hansen, R., and Gjerstad, L., 1988a, Myasthenia gravis treated with ciclosporin, Acta Neurol Scand. 77:307–313.

    Article  PubMed  CAS  Google Scholar 

  • Nyberg-Hansen, R., and Gjerstad, L., 1988b, Immunopharmacological treatment in myasthenia gravis, Transplant. Proc. 20(Suppl.4):201–210.

    PubMed  CAS  Google Scholar 

  • O’Neill, J. H., Murray, N. M. E., and Newsom-Davis, J., 1988, The Lambert-Eaton myasthenie syndrome, Brain 111:577–596.

    Article  PubMed  Google Scholar 

  • Øst, L., 1984, Effects of cyclosporin on prednisolone metabolism, Lancet 1:451.

    Article  PubMed  Google Scholar 

  • Ohta, M., Ohta, K., Mori, E., Itoh, N., Nishitani, H., and Hayashi, K., 1990, Improved radioassay of antiacetylcholine receptor antibody: Application for the detection of extremely low antibody titers in sera from patients with myasthenia gravis, Clin. Chem. 36:911–913.

    PubMed  CAS  Google Scholar 

  • Peers, C., Lang, B., and Newson-Davis, J., 1990, Selective action of myasthenie antibodies on calcium channels in a rodent neuroblastoma X glioma cell line, J. Physiol. 421:293–308.

    PubMed  CAS  Google Scholar 

  • Pestronk, A., Adams, R. N., Kuncl, R. W., Drachman, D. B., Clawson, L. L., and Cornblath, D. R., 1989, Differential effects of prednisone and cyclophosphamide on autoantibodies in human neuromuscular disorders, Neurobgy 39:628–633.

    CAS  Google Scholar 

  • Roberts, A., Perera, S., Lang, B., Vincent, A., and Newsom-Davis, J., 1985, Paraneoplastic myasthenie syndrome IgG inhibits 45Ca2+ flux in a human small cell carcinoma line, Nature (Lond.) 317:737–739.

    Article  CAS  Google Scholar 

  • Sahashi, K., Engel, A. G., Lambert, E. H., and Howard, F. M., 1980, Ultrastructural localization of the terminal and lytic ninth complement component (C9) at the motor end-plate in myasthenia gravis, Neuropathol. Exp. Neurol 39:160–171.

    Article  CAS  Google Scholar 

  • Schalke, B. C. G., Kappos, L., Rohrbach, E., Melms, A., Kalies, I., Dommasch, D, and Mertens, H.-G., 1988, Ciclosporin A vs. azathioprine in the treatment of myasthenia gravis: Final results of a randomized, controlled double-blind clinical trial, Neurobgy 38(Suppl. 1):135.

    Google Scholar 

  • Scherrer, U., Vissing, S. E., Morgan, B. J., Rollins, J. A., Tindall, R. S., Ring, S., Hanson, P., Mohanty, P. K., and Victor, R. G., 1990, Cyclosporine-induced sympathetic activation and hypertension after heart transplantation, N. Engl J. Med. 323:748–750.

    Article  Google Scholar 

  • Sher, E., Gotti, C., Canal, N., Scoppetta, C., Piccolo, G., Evoli, A., and Clementi, E., 1989, Specificity of calcium channel autoantibodies in Lambert-Eaton myasthenie syndrome, Lancet 2:640–643.

    Article  PubMed  CAS  Google Scholar 

  • Shevach, E. M., 1985, The effects of cyclosporin A on the immune system, Annu. Reu Immunol 3:397–423.

    Article  CAS  Google Scholar 

  • Simpson, J. A., 1960, Myasthenia gravis: A new hypothesis, Scot. Med. J. 5:419–436.

    Google Scholar 

  • Streib, E. W., and Rothner, A. D, 1981, Eaton-Lambert myasthenie syndrome: Long-term treatment of three patients with prednisone, Ann. Neurol. 10:448–453.

    Article  PubMed  CAS  Google Scholar 

  • Tindall, R. S. A., 1981, Humoral immunity in myasthenia gravis. Biochemical characterization of acquired antireceptor antibodies and clinical correlations, Ann. Neurol 10:437–447.

    Article  PubMed  CAS  Google Scholar 

  • Tindall, R. S. A., Rollins, J. A., Phillips, J. T., Greenke, R. G., Wells, L., and Belendiuk, G., 1987, Preliminary results of a doubleblind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis, N. Engl. J. Med. 316:719–724.

    Article  PubMed  CAS  Google Scholar 

  • Tindall, R. S. A., Phillips, J. T., Rollins, J. A., Wells, L., Hall, K., and Belendiuk, G., 1988, A double-blind, randomized, and controlled trial to compare cyclosporine and prednisone in the treatment of myasthenia gravis, Neurobgy 38(Suppl. 1):135.

    Google Scholar 

  • Vincent, A., and Newsom-Davis, J., 1980, Anti-acetylcholine receptor antibodies, J. Neurol. Neurosurg. Psychiatry 43:590–600.

    Article  PubMed  CAS  Google Scholar 

  • Walker, M., 1934, Treatment of myasthenia gravis with physostigmine, Lancet 1:1200–1201.

    Article  Google Scholar 

  • Weigert, C., 1901, Pathologisch-anatomischer Beitrag zur Erbschen Krankheit (Myasthenia gravis), Neurol. Zentralbl 20:597.

    Google Scholar 

  • Willis, T., 1672, De Amina Brutorum, Theatro Sheldoniano, Oxford.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. National Eye Institute, National Institutes of Health, Bethesda, Maryland, 20892, USA

    Robert B. Nussenblatt

Authors
  1. Robert B. Nussenblatt
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Clinical Pharmacology, The National Hospital, University of Oslo, N-0027, Oslo 1, Norway

    Hans Erik Rugstad

  2. Institute of Clinical Biochemistry, The National Hospital, University of Oslo, 0027, Oslo 1, Norway

    Liv Endresen

  3. Oslo Sanitetsforening Rheumatism Hospital, N-0172, Oslo 1, Norway

    Øystein Førre

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Science+Business Media New York

About this chapter

Cite this chapter

Nussenblatt, R.B. (1992). Immune Therapy for Autoimmune Uveitis. In: Rugstad, H.E., Endresen, L., Førre, Ø. (eds) Immunopharmacology in Autoimmune Diseases and Transplantation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1167-4_26

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-1167-4_26

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-1169-8

  • Online ISBN: 978-1-4899-1167-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation