Author: Christina Korb (Germany)
Co-authors: Sabine Beck, Norbert Pfeiffer, Franz Grus
Anti-retinal autoantibodies could play an important role in the pathogenesis of AMD. Therefore, we evaluated the serum immunoreactivities in patients with exsudative AMD and different responses to the intravitreal ranibizumab treatment.
Department of Ophthalmology, University Medical Center, Johannes-Gutenberg University Mainz, Germany.
IgG Immunreactivities were analysed in patients suffering from dry AMD (n=20), patients with treatment-naive exsudative AMD (n=29), patients with previously treated exsudative AMD and new activity (n=21) and healthy volunteers (n=21). In the group of exsudative AMD patients, serum samples were collected at baseline and after 4, 6 and 12 months, the serum was analysed by customized antigen microarrays containing 61 antigens. The statistical analysis was performed by univariate and multivariate analysis of variance, predictive data-mining methods and artificial neuronal networks were used to detect specific autoantibody patterns.
Patients with exsudative AMD were divided into those showing vision loss of more than 3 lines, no change of vision ≤3 lines or vision improvement of more than 3 lines after the 12 months treatment with ranibizumab. Highly significant changes could be observed between those immunreactivities from patients showing an improvement of vision during ranibizumab treatment and the reduced responders. Significant differences could be observed between the groups, e.g. immunoreactivities against PRG2 (p≤0,0077), Prealbumin (p≤0,0031) und Gamma-Synuclein (p≤0,0026) were up-regulated in patients improving vision and down-regulated in the group of patients that lost more than three lines of vision after one year. Immunoreactivities against D GNB1 (p≤0,021), TUBB3 (p≤0,022), ATP Synthase (p≤00,011) and PolyRp2 (p≤0,000006) were down-regulated in patients improving vision and upregulated in the group of patients with vision loss.
We report a microarray-based evaluation of serum in patients with exsudative AMD after one year of intravitreal ranibizumab treatment and different response to treatment. Significant differences in immunoreactivities between the groups with different response to treatment were observed for nine antigens associated with cellular growth and proliferation. A potential immunoproteomic prediction of response to treatment might be possible in the future.