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Editors Selection IGR 7-3
Clinical Glaucoma: sCD44 and visual field loss
Comment by Franz Grus on:
19559 Aqueous humor sCD44 concentration and visual field loss in primary open-angle glaucoma, Nolan MJ; Giovingo MC; Miller AM et al., Journal of Glaucoma, 2007; 16: 419-429
Glaucomatous optic neuropathy represents a group of neurodegenerative diseases characterized by a progressive death of retinal ganglion cells (RGCs). The involvement of the immune system and immunological mechanisms in glaucoma are discussed in several papers in the last years. The group of Michal Schwartz could show in several studies that boosting of components of the immune system can lead to neuroprotection. The group of Marty Wax could demonstrate that elevated immunoreactivities against HSP27 could be found in normal tension glaucoma patients. Our group showed that consistent up- and downregulations of immunoreactivities against ocular antigens are present in glaucoma patients and lead to changes in the natural autoimmunity. CD44 is a receptor for the matrix glycosaminoglycan hyaluronan. Proteoglycan forms of CD44 also exhibit affinity for fibronectin and collagen as well as chemokines and growth factors. CD44 is thought to play a role in autoimmunity, inflammation, and tumor progression. Soluble CD44 (sCD44) is found in plasma, and the levels of sCD44 correlate with immune function and some malignancies in many diseases. The mechanisms by which sCD44 is generated and its function are unknown. Taking these results together with the findings of the involvement of autoimmune mechanisms in glaucoma described above, Nolan et al. (854) described very interesting results in their paper. They could show that the sCD44 concentration in aqueous humor is elevated in glaucoma patients and correlated with the severity of visual field loss and thus they conclude that sCD44 could be a possible biomarker in POAG. However, the results need to be interpreted very carefully, because the analysis of aqueous humor is always hampered by the fact that normally no real 'normal' group exists. Furthermore, I would prefer to confirm these results in aqueous humor with an additional technique than the enzyme-linked immunosorbent assay used in this study.
However, the results are very encouraging and provide new aspects of the pathogenesis of glaucoma.
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