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Extra resources for Age-Related Macular Degeneration, 2nd Edition

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Antigen-Specific Immunity in Glomerular Diseases Antigen-specific immunity contributes significantly to inflammatory glomerular disorders. Lymphocytemediated immunity clearly contributes to glomerulonephritis, especially in renal allograft rejection (161). However, the relevance of this mechanism to AMD is probably minimal. Many forms of chronic glomerulonephritis are caused by antibody-dependent mechanisms, and some of these disorders are characterized by subendothelial or subepithelial deposit formation (102,162–164).

The relevance to AMD is discussed below. ” This idea proposes that interaction between antigen and the antigen-specific immune system at a peripheral site (such as the skin) can Immune Response Arc APC Afferent Dendritic Cell T CTL atic h Lymp Lymph node Tissue Site TCTL B T DH n atio cul T DH Cir Efferent Plasma Cell Figure 4 The immune response arc indicating cross-talk between the tissue site, where antigen recognition and effector processes take place, and the lymph node, the site of antigen processing.

C3 and other complement proteins can be cleaved into biologically activated fragments by various enzyme systems, in the absence of the entire cascade, to activate certain specific cellular functions. Further, complement activation inhibitors can be produced by cells within tissues, including the RPE, serving as local protective mechanism against complement-mediated injury (20,21). Recently, several components of the complement system have been identified within Bruch’s membrane and drusen indicating a potential role for complement in AMD (22).

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