CELLULAR AUTOIMMUNITY TO RETINAL SPECIFIC ANTIGENS IN PATIENTS WITH BEHCETS-DISEASE

The notion that autoimmune mechanisms play a role in the pathogenesis of certain uveitic conditions in humans is supported by the observatio n that lymphocytes from such patients respond in culture against retin al specific antigens which are uveitogenic in animals. A large proport ion of uveitis patients with Behcet's disease are reported to respond well to S antigen, to interphotoreceptor retinoid binding protein (IRB P) and to several of their uveitogenic peptides, in particular, the S antigen derived peptide M. Patients with Behcet's disease without ocul ar involvement were reported not to differ in their responses to S ant igen from the responses in the control group, yet 35% of them responde d to IRBP and approximately two thirds of them responded to the peptid es (peptide M, peptide N, R-4, or R-14). The responses were inhibited by monoclonal antibodies to CD4 and to class II MHC HLA-DR molecules. The presence of lymphocyte responses to retinal antigens in patients w ith Behcet's disease without uveitis might indicate a preclinical stag e of ocular involvement. Thus, these data support the idea that autoim munity to retinal specific antigens may play a role in the ocular infl ammation in Behcet's disease.