eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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1/2021
vol. 46
 
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abstract:
Review paper

New perspectives of immunomodulation and neuroprotection in glaucoma

Piotr Skopiński
1, 2
,
Dorota Magdalena Radomska-Leśniewska
1
,
Justyna Izdebska
2, 3
,
Anna Kamińska
2, 3
,
Magdalena Kupis
2, 3
,
Aleksander Jan Kubiak
4
,
Katarzyna Samelska
2, 3

1.
Department of Histology and Embryology, Medical University of Warsaw, Warsaw, Poland
2.
SPKSO Ophthalmic University Hospital, Warsaw, Poland
3.
Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
4.
Rutgers New Jersey Medical School, Newark, NJ, United States
Cent Eur J Immunol 2021; 46 (1): 105-110
Online publish date: 2021/03/11
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Glaucoma is the neurodegenerative disease of retinal ganglion cells. The main risk factor for glaucoma is increased intraocular pressure. The processes leading to cell death due to presence of the injury factor comprise multiple molecular mechanisms, as well as the immunological response. The knowledge of immunological mechanisms occurring in glaucomatous degeneration makes it possible to introduce glaucoma treatment modulating the cellular degradation. The glaucoma treatment of the future will make it possible not only to lower the intraocular pressure, but also to moderate the intracellular mechanisms in order to prevent retinal cell degeneration. Citicoline is a drug modulating glutamate excitotoxicity that is already in use. Rho kinase inhibitors were found to stimulate neurite growth and axon regeneration apart from lowering intraocular pressure. The complementary action of brimonidine is to increase neurotrophic factor (NTF) concentrations and inhibit glutamate toxicity. Immunomodulatory therapies with antibodies and gene therapies show promising effects in the current studies. The supplementation of NTFs prevents glaucomatous damage. Resveratrol and other antioxidants inhibit reactive oxygen species formation. Cell transplantation of stem cells, Schwann cells and nerve extracts was reported to be successful so far. Our review presents the most promising new strategies of neuroprotection and immunomodulation in glaucoma.
keywords:

brimonidine, growth factors, retinal ganglion cells (RGCs), Rho kinase inhibitors, stem cell therapy, citicoline

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