Manifestations of immunopathology and validation of immunotherapy of diabetic retinopathy

Three-year clinical and immunological studies of 378 patients with diabetic retinopathy revealed involvement of the T- and B-immunity systems and the specific features of the local autoimmune response to the retinal S-antigen, which manifest during the early preclinical stage of diabetic retinopathy. The progress of retinopathy is associated with augmenting insufficiency of T-suppressors, inhibition of lymphocyte blastogenesis with phytohemagglutinin, and an increase in the levels of B-lymphocytes, IgM, and circulating immune complexes in the blood. Two abnormalities of autoimmune response of the eye to S-antigen were observed in patients with the proliferative forms: hypersensitivity and insufficiency of the immune response. A moderate level of S-antigen in tears is a protective factor, stabilizing retinopathy. The authors validate the significance of immunological test for predicting the course of retinopathy and emphasize the differentiated approach to local and total-system's correction of immune disorders in diabetics.