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Association of uvietis following extracapsular lens extraction with DQW1
Abstracts
203 Since we have shown that the D Q w l . 1 pattern is also found in D R w l 4 - D w 9 haplotypes, we are presently studying DRw6 + and DRw8 + IDD patients to determine whether these specificities, in IDD patients, are also associated with the D Q w l . 1 RF pattern. These data will be presented. The association of DR4 with I D D has been extensively studied in order to identify specific elements of DR4 + haplotypes relevant to IDD. However, both the subtype Dw4, which is increased in DR4 + I D D patients as compared to controls, and the D Q beta RF pattern DQw3.2, which contains RFs reported to be increased in DR4 + I D D patients as compared to controls, are also found in DR4 + haplotypes which are not, or are even negatively, associated with IDD. We have recently identified RF patterns which suggest that haplotypes carrying the DQw3.2 pattern include more than one subset defined by RF analysis. Very preliminary data indicate that only one of these subsets is associated with IDD. The various patterns obtained, and their disease associations, will be presented.
ASSOCIATION OF UVEITIS FOLLOWING EXTRACAPSULAR LENS EXTRACTION WITH DQW1. L DeLozier, AA Zachary, DM Meisler, GA Teresi, and WE Braun; Cleveland Clinic Foundation, Cleveland, OH Cases o f delayed-post-operative intraocular inflammation have been reported recently in patients who have had extracapsular cataract extractions and posterior chamber intraocular lens implants. The clinical nature of this inflammation, i.e., a chronic, "granulomatous" appearance, has prompted Apple et al. (1984) to suggest that the inflammation may be due to a hypersensitivity to the lens cortex left in the eye after the extracapsular technique. Animal models have suggested that autoimmunity to lens cortex is controlled by immune response genes (Misra et al., 1977). We performed HLA typing of 20 Caucasian patients who had uveitis following extracapsular lens extraction and posterior chamber lens implantation. All 20 patients had uneventful immediate postoperative courses but subsequently developed a chronic, indolent intraocular inflammation which had the appearance of "granulomatous" iridocylitis. Eighteen of 20 (f = 0.90) patients possessed DQW1 which is a significant increase over controls (f = 0.58). Propionibacterium aches, an anaerobic bacillus with known immunopotentiating properties, was isolated from intraocular aspirates from five of the patients (one DQwl-). Failure to find P. aches uniformly may be due to the absence of the organism in the remaining 15 patients, in sufficient culture time, or the presence in the intraocular material o f nonviable bacteria. This inflammatory process may represent a suppressed response to bacteria similar to that seen in lepromatous leprosy, another DQwl-associated disease. However, the frequency of DR2 among D Q w l haplotypes in these two diseases, which is significantly elevated in lepromatous leprosy and decreased (0.1 > p > 0.05) in our uveitis patients, suggests that the different subtypes of D Q w l defined in the Ninth International Workshop may be involved in the different diseases. A second possible mechanism is an autoimmunity to lens cortex, facilitated in the presence of the appropriate class II gene(s), and immunopotentiating agents such as P. aches and the polymethacrylate lens inplant. In vitro studies are underway to differentiate among the possible mechanisms.
CLINICAL USEFULNESS OF HLA ANTIBODY ANALYSIS OF ALLOIMMUNIZEDTHROMBOCYTOPENIC PATIENTS REQUIRING PLATELET TRANSFUSIONS. Marilyn Marrari, Arsinur Oral, and Rene J. Duquesnoy; Central Blood Bank of Pittsburgh, Pittsburgh, PA
203 Since we have shown that the D Q w l . 1 pattern is also found in D R w l 4 - D w 9 haplotypes, we are presently studying DRw6 + and DRw8 + IDD patients to determine whether these specificities, in IDD patients, are also associated with the D Q w l . 1 RF pattern. These data will be presented. The association of DR4 with I D D has been extensively studied in order to identify specific elements of DR4 + haplotypes relevant to IDD. However, both the subtype Dw4, which is increased in DR4 + I D D patients as compared to controls, and the D Q beta RF pattern DQw3.2, which contains RFs reported to be increased in DR4 + I D D patients as compared to controls, are also found in DR4 + haplotypes which are not, or are even negatively, associated with IDD. We have recently identified RF patterns which suggest that haplotypes carrying the DQw3.2 pattern include more than one subset defined by RF analysis. Very preliminary data indicate that only one of these subsets is associated with IDD. The various patterns obtained, and their disease associations, will be presented.
ASSOCIATION OF UVEITIS FOLLOWING EXTRACAPSULAR LENS EXTRACTION WITH DQW1. L DeLozier, AA Zachary, DM Meisler, GA Teresi, and WE Braun; Cleveland Clinic Foundation, Cleveland, OH Cases o f delayed-post-operative intraocular inflammation have been reported recently in patients who have had extracapsular cataract extractions and posterior chamber intraocular lens implants. The clinical nature of this inflammation, i.e., a chronic, "granulomatous" appearance, has prompted Apple et al. (1984) to suggest that the inflammation may be due to a hypersensitivity to the lens cortex left in the eye after the extracapsular technique. Animal models have suggested that autoimmunity to lens cortex is controlled by immune response genes (Misra et al., 1977). We performed HLA typing of 20 Caucasian patients who had uveitis following extracapsular lens extraction and posterior chamber lens implantation. All 20 patients had uneventful immediate postoperative courses but subsequently developed a chronic, indolent intraocular inflammation which had the appearance of "granulomatous" iridocylitis. Eighteen of 20 (f = 0.90) patients possessed DQW1 which is a significant increase over controls (f = 0.58). Propionibacterium aches, an anaerobic bacillus with known immunopotentiating properties, was isolated from intraocular aspirates from five of the patients (one DQwl-). Failure to find P. aches uniformly may be due to the absence of the organism in the remaining 15 patients, in sufficient culture time, or the presence in the intraocular material o f nonviable bacteria. This inflammatory process may represent a suppressed response to bacteria similar to that seen in lepromatous leprosy, another DQwl-associated disease. However, the frequency of DR2 among D Q w l haplotypes in these two diseases, which is significantly elevated in lepromatous leprosy and decreased (0.1 > p > 0.05) in our uveitis patients, suggests that the different subtypes of D Q w l defined in the Ninth International Workshop may be involved in the different diseases. A second possible mechanism is an autoimmunity to lens cortex, facilitated in the presence of the appropriate class II gene(s), and immunopotentiating agents such as P. aches and the polymethacrylate lens inplant. In vitro studies are underway to differentiate among the possible mechanisms.
CLINICAL USEFULNESS OF HLA ANTIBODY ANALYSIS OF ALLOIMMUNIZEDTHROMBOCYTOPENIC PATIENTS REQUIRING PLATELET TRANSFUSIONS. Marilyn Marrari, Arsinur Oral, and Rene J. Duquesnoy; Central Blood Bank of Pittsburgh, Pittsburgh, PA