February 10, 2018

Download PDF by I. Lim Jennifer: Age-Related Macular Degeneration, 2nd Edition

By I. Lim Jennifer

ISBN-10: 0849372143

ISBN-13: 9780849372148

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Locally synthesis or blood-derived) as well as the mechanisms for activation (typical cascades vs. enzymatic cleavage) remain unknown. Finally, oxidants have been implicated as important mediators and amplifiers in progression of renal disease (173). Direct Evidence for Innate or Antigen-Specific Immune Effectors Direct evidence for the role of immune mechanism in AMD is scant. The best data suggest an important role for macrophage-mediated innate immunity (22,50–58). Investigators have observed that choroidal macrophages appear to be important in the pathogenesis of both early and late AMD.

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).

Amplification Mechanisms for Both Forms of Immunity Although innate or antigen-specific immunity may directly induce injury or inflammation, in most cases, these effectors initiate a process that must be amplified in order to produce overt clinical manifestations. Molecules generated within tissues which amplify immunity are termed “mediators”, and several categories of molecules qualify including: (i) cytokines (growth factors, angiogenic factors, others), (ii) oxidants (free radicals, reactive nitrogen), (iii) plasma-derived enzyme systems (complement, kinins, and fibrin), (iv) vasoactive amines (histamine and serotonin), (v) lipid mediators [prostaglandins (PGs), leukotrienes, other eicosanoids, and platelet activating factors], and (vi) neutrophil-derived granule products.

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Age-Related Macular Degeneration, 2nd Edition by I. Lim Jennifer

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