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    Why immunomodulation is the next logical step in glaucoma control

     

    Dr. TezelNew York—Research in glaucoma that evaluates the molecular interactions between resident and systemic immune cells and neurons is progressing with the goal of providing translational applications for immunomodulation as a neuroprotective strategy in patients with glaucoma, said Gülgün Tezel, MD.

    The immune system preserves and restores tissue, but prolonged glial activation and continuous release of proinflammatory mediators can result in failure of the immune response. Glial cytotoxicity, autoreactive T-cells, autoantibodies, and excess complement activation are potent stimuli for injury to retinal ganglion cell (RGC) somas, axons, and synapses in glaucoma. Treatments to target these factors should control glaucoma progression, Dr. Tezel said.

    More from this issue: Nicox, B+L to co-promote glaucoma treatment in U.S.

    “In addition to elevated IOP, multiple factors impact the cellular homeostasis in glaucoma,” explained Dr. Tezel, professor, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York. “Current findings have identified interconnected downstream pathways of cellular processes in RGCs that become exposed to glaucomatous stress, that is, mitochondrial dysfunction, proteolytic caspase cascade, endoplasmic reticulum stress, and oxidative stress.”

     

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