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Limited Peripheral T Cell Anergy Predisposes to Retinal Autoimmunity¹

Teresa Lambe^*, Janson C. H. Leung^*, Helen Ferry^*, Tiphaine Bouriez-Jones^*, Kimmo Makinen, Tanya L. Crockford^*, Hui R. Jiang, John M. Nickerson, Leena Peltonen, John V. Forrester and Richard J. Cornall^2,*

^* Henry Wellcome Building of Molecular Physiology, Oxford, United Kingdom; Department of Ophthalmology, University of Aberdeen, Foresterhill, Aberdeen, Scotland, United Kingdom; Department of Ophthalmology, Emory University, Atlanta, GA 30322; and Department of Medical Genetics and Molecular Medicine, University of Helsinki and National Public Health Institute, Biomedicum Helsinki, Helsinki, Finland

Autoimmune uveoretinitis accounts for at least 10% of worldwide blindness, yet it is unclear why tolerance to retinal Ags is so fragile and, particularly, to what extent this might be due to defects in peripheral tolerance. To address this issue, we generated double-transgenic mice expressing hen egg lysozyme, under the retinal interphotoreceptor retinoid-binding promoter, and a hen egg lysozyme-specific CD4⁺ TCR transgene. In this manner, we have tracked autoreactive CD4⁺ T cells from their development in the thymus to their involvement in uveoretinitis and compared tolerogenic mechanisms induced in a variety of organs to the same self-Ag. Our findings show that central tolerance to retinal and pancreatic Ags is qualitatively similar and equally dependent on the transcriptional regulator protein AIRE. However, the lack of Ag presentation in the eye-draining lymph nodes results in a failure to induce high levels of T cell anergy. Under these circumstances, despite considerable central deletion, low levels of retinal-specific autoreactive CD4⁺ T cells can induce severe autoimmune disease. The relative lack of anergy induction by retinal Ags, in contrast to the same Ag in other organs, helps to explain the unique susceptibility of the eye to spontaneous and experimentally induced autoimmune disease.

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

¹ This work was supported by The Wellcome Trust.

² Address correspondence and reprint requests to Dr. Richard J. Cornall, Henry Wellcome Building of Molecular Physiology, Roosevelt Drive, Oxford, OX3 7BN, U.K. E-mail address: rcornall{at}ccmp.ox.ac.uk

³ Abbreviations used in this paper: EAU, experimental autoimmune uveoretinitis; Treg, regulatory T cell; IRBP, interphotoreceptor retinoid-binding protein; AIRE, autoimmune regulator; KO, knockout; WT, wild type; HEL, hen egg lysozyme; rHEL, retinal HEL; mHEL, membrane-bound HEL; insHEL, pancreatic expressed HEL; sHEL, soluble HEL; DC, dendritic cell; AFC, Ab-forming cell.