RETINAL ANTIGEN-SPECIFIC LYMPHOCYTES, TCR-GAMMA-DELTA T-CELLS AND CD5(-CELLS CULTURED FROM THE VITREOUS IN ACUTE SYMPATHETIC OPHTHALMITIS()B)

CD5(+) B lymphocytes and TCR gamma-delta T lymphocytes, phenotypes imp licated in the pathogenesis of autoimmune disease, were isolated from the vitreous in a case of acute sympathetic ophthalmitis. These cells were obtained using a method which allows the selective maintainance i n vitro of in vivo activated T lymphocytes. Dual colour flow cytometry showed that after 3 days culture in IL-2 containing medium 61% of cel ls were CD5/CD19+ and 41% CD3/TCR gamma delta +ve. Of the total CD3+ve population, 15% were gamma/delta negative. These cells formed a popul ation which also responded in a proliferation assay to retinal antigen s. Histologically the eye showed a marked mononuclear cell infiltratio n of the retina, ciliary body and choroid. Granulomatous lesions withi n the choroid contained lymphocytes,plasma cells and multinucleate gia nt cells. Immunocytochemistry showed lymphocyte populations to be pred ominantly CD2+ve CD3+ve T lymphocytes of the CD4 sub-set. Distribution of monocytes/macrophages throughout the lesions and restriction of B- lymphocytes to granulomata were all consistent with a DTH type reactio n. Despite immunosuppressive therapy, the expression of activation ant igens HLA-DR and ICAM-1 on infiltrating and resident ocular tissue cel ls was high, although IL-2 receptor (CD25) expression was virtually ab sent. Flow cytometric analysis of peripheral blood cells prior to trea tment with Cyclosporin-A showed systemic activation of lymphocytes, wi th high levels of HLA-DR and CD25 expression and a raised CD4/CD8 rati o.