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The role of the adaptive immune system and T cell dysfunction in neurodegenerative diseases

Alexa DeMaio, Shikhar Mehrotra, Kumar Sambamurti and 1 more

Journal of Neuroinflammation · 2022 · Review · CC BY

doi:10.1186/s12974-022-02605-9

Abstract

The adaptive immune system and associated inflammation are vital in surveillance and host protection against internal and external threats, but can secondarily damage host tissues. The central nervous system is immune-privileged and largely protected from the circulating inflammatory pathways. However, T cell involvement and the disruption of the blood–brain barriers have been linked to several neurodegenerative diseases including Parkinson's disease, Alzheimer’s disease, and multiple sclerosis. Under normal physiological conditions, regulatory T cells (Treg cells) dampen the inflammatory response of effector T cells. In the pathological states of many neurodegenerative disorders, the ability of Treg cells to mitigate inflammation is reduced, and a pro-inflammatory environment persists. This perspective review provides current knowledge on the roles of T cell subsets (e.g., effector T cells, Treg cells) in neurodegenerative and ocular diseases, including uveitis, diabetic retinopathy, age-related macular degeneration, and glaucoma. Many neurodegenerative and ocular diseases have been linked to immune dysregulation, but the cellular events and molecular mechanisms involved in such processes remain largely unknown. Moreover, the role of T cells in ocular pathologies remains poorly defined and limited literature is available in this area of research. Adoptive transfer of Treg cells appears to be a vital immunological approach to control ocular pathologies. Similarities in T cell dysfunction seen among non-ocular neurodegenerative diseases suggest that this area of research has a great potential to develop better therapeutic agents for ocular diseases and warrants further studies. Overall, this perspective review article provides significant information on the roles of T cells in numerous ocular and non-ocular neurodegenerative diseases.

Full text

From PubMed Central, U.S. National Library of Medicine, as current on Oct 22, 2026. Paragraph numbers are ours, so an answer can point at one.

Adaptive immune responses and pathological conditions

The immune system can be divided into innate and adaptive immune responses and is designed to protect the body from disease-causing pathogens. The innate immune system is the body's first line of defense and requires no lag time to mount a response to infection. Innate immunity is largely nonspecific. Adaptive immunity is much more specific and provides long-lasting protection against pathogens. The cells that carry out adaptive immune responses are called lymphocytes and are classified into B lymphocytes and T lymphocytes, which accomplish humoral and cell-mediated immune responses, respectively. In the humoral immune response, a B cell receptor reacts with a specific antigen stimulating the cell to synthesize and secrete antibodies, also known as immunoglobulins. These antibodies play crucial roles in neutralizing pathogens. Antibodies recognize epitopes on a single specific molecule (e.g., protein or carbohydrate) called an antigen. When an antigen, such as a virus or microbial toxin (e.g., tetanus or diphtheria toxin), binds an antibody, it can no longer bind to receptors on host cells and is therefore neutralized. T lymphocytes (T cells) arise in the bone marrow and mature in the thymus. They are classified into two major categories CD8 + and CD4 + cells based on their effector functions and recognition of different classes of MHC molecules. CD8 + cells defend the host against intracellular pathogens such as viruses and cancer, as they can detect surface antigens displayed by infected cells. Cytotoxic CD8 + cells do not recognize free antigens but bind short peptide antigens expressed on the major histocompatibility complex (MHC) class I protein on the surface of most cells. MHC class I molecules are found on all nucleated cells and are important in T cell activity against viruses, but MHC class II molecules are only found on APCs, which help with the proliferation of B cells. An antigen-presenting cell (APC; e.g., dendritic cells, macrophages, Langerhans cells, and B cells) must stimulate a cytotoxic T cell to activate it. A pathogen-activated APC will subsequently travel to secondary lymphoid tissues, such as lymph nodes. After activation by an APC, the T cell will expand its population to eliminate the specific pathogen. Once a population of T cells has been created to combat pathogens, memory T cells will provide lifelong immunity against the pathogen. Mechanistically, CD8 + T cells bind to MHC class I, whereas CD4 + T cells bind to MHC class II. Once a CD8 + T cell has been primed by an APC cell, it is activated and ready to kill infected or invading cells. When the CD8 + T cell binds to its target antigen on the surface of an infected cell, it will release lytic granules containing perforins and granzymes that create pores in the target cell membrane or it induces apoptosis via Fas ligand and caspase activation. In addition, CD8 + T cells release cytokines including IFN-γ, TNF-α, and TNF-β. These cytokines will further inhibit viral replication, activate macrophages, and upregulate MHC class I expression. MHC class I expression increases the detection of an infected cell, as T cells cannot recognize cells without MHC molecules.

CD4 + T cells were originally subdivided into two groups based on their effector functions: Th1 and Th2 cells. These Th1 and Th2 cells are antagonistic and maintain a balance under physiological conditions. Th1 cells, generally, secrete pro-inflammatory molecules such as IFN-γ, TNF-α, TNF-β, and IL-1β; while Th2 cells counteract inflammation with IL-4, IL-5, IL-6, IL-10, and IL-13. Until the mid-1990s, scientists were not aware of other subsets of CD4 + cells, but now CD4 + T cells have been expanded further into Th9, Th17, Th22, Treg cells, and T follicular cells. Th9, Th17, and Th22 T cell subsets secrete different pro-inflammatory cytokines and have been implicated in autoimmune and inflammatory diseases. For example, in allergic asthma Th2, Th9, and Th17 cells play a role in the pathogenesis of the disease through cytokine secretion and the activation of mast cells and eosinophils, which leads to airway hyperactivity. While the ability of T cells to cause inflammation may be necessary for proper immune function, a mechanism to regulate this response is also required. T regulatory (Treg) cells have been shown to play key roles in their regulation. As evident from the name, Treg cells regulate and suppress the potentially dangerous effects of T cells and ultimately promote tolerance. Numerous functions of Treg cells have been documented including suppression of asthma and allergy, induction of tolerance to dietary antigens, protection of commensal bacteria from elimination by the immune system, promotion of maternal–fetal tolerance, and prevention of autoimmune disease. The role of Treg cells is not fully understood, and it remains a key area of research, specifically in ocular pathology. However, it has become increasingly clear that Treg cells are required to maintain homeostasis. As referenced above, a hyperactive inflammatory immune response can harm host cells. Conversely, a lack of a properly functioning immune system can lead to life-threatening infections, so a balance must be struck between the two states. Treg cells maintain this balance by playing a suppressive role and preventing a pro-inflammatory response. Numerous disease conditions such as systemic sclerosis, gestational diabetes, atherosclerosis, COPD, among many others have reported T cell subsets imbalance as a causative factor in disease pathogenesis.

Tolerance and autoimmunity

The immune system is designed to target foreign pathogens and leave host cells unharmed via a process known as tolerance. Autoimmunity occurs when a host loses self-tolerance. In other words, autoimmunity is a process of an immune response against the host leading to self-cell damage. Different autoimmune conditions can target specific areas of the body like pemphigus vulgaris and pemphigoid, which targets the skin, or systemic lupus erythematosus which is disseminated and targets the entire body. An important aspect of autoimmunity is the presence of autoreactive lymphocytes. Auto-reactivity can be triggered through molecular mimicry, which is immunological cross-reactivity between host and foreign antigens. In this condition, foreign antigens closely resemble host antigens resulting in an erroneous self-directed attack on host tissue. Autoreactive lymphocytes can also develop during the initial lymphocyte creation. When lymphocytes undergo genetic rearrangement, some are reactive against self-antigens, but under homeostatic conditions these lymphocytes undergo thymic deletion and undergo apoptosis. Although up to 98% of T cells do not make it through the selection process, some autoreactive lymphocytes will escape the process of elimination even in healthy individuals. One of the functions of Treg cells is to prevent the activation of these autoreactive lymphocytes and therefore protect the body from self-attack. FoxP3 knockdown, a marker for Treg cells, leads to a loss of functional Treg cells in Scurfy mice. The lack of Treg cells leads to a fatal autoimmune response by 3–4 weeks of age, demonstrating their critical role in immune tolerance. T cell activation suppression via the induction of anergy, a long-term state of T cell hypo-responsiveness, is the second mechanism of its modulation. Inducing anergy will prevent T cells from undergoing clonal proliferation, providing another potential fail-safe against autoimmunity. Recent studies have shown a strong connection between Treg cells and anergy, anergic T cells can convert into Treg cells, suggesting that persistent anergic T cells may serve as a reservoir for Treg cells, though the mechanism remains largely unknown.

Autoimmune diseases affect millions of people with increasing frequency in developing countries, making them an important area of study. Some autoimmune conditions are hereditary, and many primarily affect women, but they typically require a trigger or underlying susceptibility. Autoimmunity is multifactorial and involves genetic, environmental, hormonal, immunological, and unknown triggers. Modifiable risk factors for autoimmune diseases include infection, vaccination, drugs, smoking, UV light exposure and obesity. Studies have also shown that people with autoimmune diseases are less active than the rest of the population, suggesting physical activity may play a regulatory role in autoimmunity.

Adaptive immunity and Alzheimer’s disease

Alzheimer’s disease (AD) is a neurodegenerative disorder and one of the most common causes of senile dementia worldwide. The loss of memory and cognitive decline was seen in AD is progressive, irreversible, and is usually seen in the elderly population. Characteristic features of the disease are the accumulation of β-amyloid plaque deposits as well as neurofibrillary tangles of hyper-phosphorylated tau in the brain. However, the familial AD (FAD) mouse models combined with frontotemporal dementia-linked human microtubule associated tau fail to show the extensive and progressive neurodegeneration reported in human patients. Therefore, there is a major gap in our understanding of the steps leading to neurodegeneration and irreversible dementia. The evidence for immune system involvement in AD is compelling. Several studies have implicated both microglia and the innate immune system in the neurodegeneration seen in AD. Studies have also shown the involvement of the adaptive immune system in the pathology of AD. T cells have been identified in the brain parenchyma of postmortem Alzheimer’s patients and T cell abnormalities have also been identified in the blood and cerebral spinal fluid of Alzheimer’s patients. Studies in a mouse model have also shown that β-amyloid promotes T cell infiltration, and it interferes with proper T cell functioning, including activation and antigen presentation, suggesting that failure to mount a protective immune response may contribute to AD pathology. A breakdown in antigen presentation may contribute to an immune inability to clear β-amyloid. Alterations in the peripheral lymphocyte profiles have also been demonstrated in Alzheimer’s disease. Recently, studies have also shown an association between higher levels of CD 4 + cell counts and an increased risk of AD. Most research has focused on T cells in AD, but a few recent findings have also highlighted the roles of B cells in the disease. One study suggests that B cell depletion may prevent disease progression, which is an interesting theory in light of recent identification of resident B cells in the dura matter. This data suggests that alterations in B lymphocyte number, subsets, and production of autoantibodies may all be involved in AD pathology and progression of the disease.

Recent studies focusing on cerebrospinal fluid (CSF) biomarkers have consistently disregarded the cellular infiltrates, treating them as artifacts of collection. However, a careful examination of CSF by cutting-edge methods of mass cytometry, revealed a consistent increase in CD8+ T effector memory CD45RA+ (TEMRA) cells, and their association with cognitive impairment. Additionally, single-cell RNA sequencing and artificial intelligence revealed an increase in T cell receptor (TCR) signaling, and further analysis identified clonally expanded CD8+ TEMRA cells targeting Epstein–Barr viral antigens. These studies show that T cells in the CSF play the same role as peripheral T cells in surveillance and maintenance of the intrathecal space. The existence of immune plasticity can be both beneficial and detrimental, depending on the target, extent of activity, and resolution of the inflammatory cascade. This complex pathway is consistent with findings showing that depletion of T cells prevented hippocampal infiltration and spatial memory deficits in AD models. Acute inflammatory responses may be neuroprotective and promote plaque clearance, but chronic inflammatory responses may be detrimental due to excessive collateral tissue damage. Therefore, lymphocyte physiology is altered during AD pathogenesis and these changes likely play a role in the progression of the disease.

Immunotherapy is an area of high interest in AD. The recent approval of a monoclonal antibody called aducanumab that selectively targets aggregated forms of amyloid β in AD patients may help in preventing early disease progression. This antibody is produced using selectively reactive B cells, and shows that the adaptive immune system may hold the key for better AD treatments and prognoses. However, the approval of aducanumab has been met with controversy and many questions arose about the efficacy of this drug. While the clinical success of aducanumab remains in question, immunotherapy using other antibodies will continue to be the focus of research for future drug development in this field. Overall, research involving monoclonal antibodies that recruit T cells (e.g., effector T cells and Tregs) to target amyloid β may hold promise in restoring the disrupted immune balance in AD.

Adaptive immunity and Parkinson’s disease

Parkinson’s disease (PD) is another example of an inflammatory disease process causing progressive neurodegeneration of the dopaminergic neurons in the substantia nigra of the brain. Aggregates of misfolded α-synuclein (α-syn protein accumulate in the brain of PD patients, similar to the protein aggregates observed in Alzheimer’s disease. Patients suffering from PD experience motor symptoms such as tremors, muscle rigidity, and slowness of movement (bradykinesia but they can also experience cognitive impairment. The involvement of immune cells in PD has been suggested. For example, studies have shown activated microglia in the substantia nigra of postmortem Parkinson’s disease patients and potential role of the adaptive immune system in PD has been shown.

Parkinson’s disease is considered to be a systemic inflammatory disorder because elevated pro-inflammatory cytokines are found in the blood of PD patients. An increased level of inflammatory cytokines is believed to be due to T cell activation. Studies have shown that activation of T cells in response to Parkinsonian α-synuclein peptides and the inflammation observed in PD could be, partly, due to the involvement of autoreactive T cells. Autoreactive T cells are central to autoimmune pathology, so their presence may suggest the disease is autoimmune in nature. Autoimmune conditions are also characterized by the creation of autoantibodies by B cells against self-antigens which has been demonstrated in the peripheral blood of PD patients. Recently, a study has shown an alteration in B cells population, which may play a role in PD. Additionally, studies have also shown abnormal profiles of B cells and T follicular cells, indicating a polarization towards an inflammatory phenotype.

Regardless of the autoimmune nature of Parkinson’s disease, T cells, and the adaptive immune system are believed to contribute to the disease development. Several studies reported a Th1 bias in PD patients and experimental animal models. As Th1 cells are pro-inflammatory, a shift favoring their expansion is congruent with the theory that neuroinflammation plays a role in PD. Another study has shown that CD4 + cells were the primary mediator of dopaminergic damage, while other studies have shown a decrease in the circulating CD4 + cell population in PD. If CD4 + T cells are the main mediators of disease, decreased circulating levels seem contradictory. However, the overall decrease in CD4 + T cells may be attributed to a decrease in Th17, Th2, and Treg cells and not the Th1 lineage. Maintenance of the Th1 lineage despite a decrease in the other subsets would still fit with the studies citing a Th1 bias, though not all studies are in agreement. One study marked an observed increase in the proportional CD4 + and CD3 + T cells as well as the CD4 + /CD8 + ratio in PD patients; whereas, another study showed a decrease in the CD3 +, CD8 + T cells and B lymphocyte subsets in addition to a decrease in CD4 + T cells. Reasons for a decrease in the CD4 + T cell population may be explained by a study done by Calopa et al. which found increased susceptibility to apoptosis in the CD4 + T cells in the peripheral blood of PD patients. Other conflicting data exist on the Th17 subset. While Kustrimovic et al. found that Th17 cells were decreased in the blood of PD patients, other studies have found that peripheral Th17 cells were increased in PD patients. There is conflicting evidence on the relative prevalence of each subset level, but overall, many abnormalities in T cells subsets populations have been reported in PD in favor of an inflammatory phenotype. More research is needed to clarify how effector T cell populations are affected in PD.

Treg cells likely play an opposing role in PD to the inflammatory T cell subsets by suppressing their effector functions and preventing rampant inflammation. This hypothesis is supported by studies that showed that the transfer of Treg cells could provide neuroprotection in mouse models of PD. The beneficial nature of Treg cells in PD may explain why global T cell deficiency worsened the motor deficits seen in a Parkinson mouse model by decreasing effector T cells and inadvertently reducing the protective effects of Treg cells. However, as PD is plagued by neuroinflammation, it is evident that Treg cells cannot properly execute their job for unknown reasons, and this dysfunction may contribute to disease progression. The idea that Treg cells are unable to adequately function is supported by a study that has shown an impaired ability of Treg cells to suppress effector T cells in PD. This breakdown of functioning furthers the theory that an inflammatory imbalance is observed in PD. In spite of discrepancies relating to T cell subset numbers, a change in the ability of Treg cells to function properly would result in homeostatic deviations regardless of cell numbers. More research is needed to clarify the uncertainties in the field, but most of the literature available suggests that the inflammation observed during PD is partly due to a T cell subset imbalance, which favors inflammation. Better understanding of the mechanisms behind PD and how the immune system is involved will hopefully lend to the development of effective therapies for PD.

Adaptive immunity and multiple sclerosis

Multiple sclerosis (MS) is another neurodegenerative disease of the central nervous system that causes motor and sensory deficits. The main hallmark of the disease is the presence of disseminated focal lesions or plaques in the CNS where demyelination and gliosis occur with relative axonal sparing. Multiple sclerosis is an inflammatory disease similar to other neurodegenerative conditions, with macrophages and microglia contributing to the pathology. Other peripheral immune cells are also likely to be involved in the demyelination, including T cells (CD4 + and CD8 +), B lymphocytes, plasma cells, and dendritic cells, and interactions between macrophages and lymphocytes may be part of the underlying pathogenesis.

Autoreactive T cells are an important part of autoimmune pathology in MS. Due to the extensive involvement of lymphocytes in MS plaques, the question has been raised as to whether the cause of the inflammation observed in MS may be autoimmune-dependent. A widely used animal model of MS, known as experimental autoimmune encephalomyelitis (EAE), is largely CD4 + T cell-driven. Moreover, data have shown a link between CD4 + cytotoxic lymphocytes, disease severity, and plaque activity in MS patients. Despite haziness surrounding the underlying cause of the inflammation seen in MS, the evidence of T cell involvement is strong. It has been shown that activated T cells can induce experimental autoimmune encephalomyelitis in healthy mice and that global reduction of most lymphocytes via alemtuzumab can improve MS pathology. Th1 cells have been implicated as important detrimental players in MS due to their ability to stimulate M1 macrophages through the secretion of TNF‐α and IFN‐γ, which are important mediators of inflammation and cellular damage. Most of the earlier research in MS focused on the role of T cells, however, recently researchers have also acknowledged a cooperation between B cells and T cells in MS pathogenesis. For example, B cells have been shown to work in tandem with T cells in human MS pathology. Though more research is needed on the interplay between T cells and B cells in multiple sclerosis, a similar shift towards a pro-inflammatory B cell state has been suggested. The mechanisms involved in B cell-induced pathology in MS remains largely unknown. As of 2019, all approved MS disease-modifying therapies impact B cells in some way, such as depletion of CD20 + B cells. However, not all B cell targeted therapies in MS have created positive results. One clinical trial using an experimental B cell depleting therapy for MS was terminated early due to worsening of disease progression. This suggests that the role of B cells in MS is complex, and more research is needed to better understand the exact roles of B cells in MS pathology.

Unlike the harmful effects of the inflammatory T cell subsets discussed, Treg cells are likely protective in MS. For example, the transfer of myelin oligodendrocyte glycoprotein specific Treg cells displayed dose-dependent protection against experimental autoimmune encephalomyelitis. Inflammation in MS pathology may be in part due to a decrease in Treg cells, or functionality. A reduced capacity of naïve CD4 + T cells to differentiate into Treg cells under pathological conditions has also been demonstrated. A reduction in number or function of Treg cells would mean a decreased capacity for inflammatory suppression. On the other hand, some studies have shown relative increases in the levels of Treg cells in MS, but reduced functionality. This may suggest Treg cells functionality may be more consequential in MS pathology than the number itself. Although more research is needed to clarify how each subset of T cells is involved in MS, current data suggest that a failure in Treg cell number and or functioning combined with an upregulation of effector T cells contribute to the inflammation and CNS damage seen in MS. A deeper understanding of T cells interaction within MS will hopefully lead to new therapy. Interventions that downregulate effector T cells or upregulate Treg cells may decrease the disease progression in MS patients.

Adaptive immunity and the eye

The eye is an “immune privileged” organ, which limits its inflammatory immune response so that vision is not harmed by swelling, infection, and other tissue changes. The eye is similar to the brain, testes, placenta, and fetus in regard to immune responses. Typically, even foreign antigens do not trigger immune responses in these organs. In addition, the blood–retinal barriers in the eye stop infiltration of blood-borne pathogens and immune cells under physiological conditions. However, under pathological conditions such as uveitis, glaucoma, diabetic retinopathy, and retinal ischemia, numerous immune cells can infiltrate the eye and may induce or facilitate autoimmunity that can lead to the development of autoimmunity.

In general, if an immune-privileged organ is damaged, previously insulated proteins will be exposed to peripheral immune cells that have not encountered these “novel” antigens. Having never come across these antigens before, peripheral immune cells have not learn to recognize them as self, allowing the generation of autoreactive lymphocytes. The immune-privileged status of the eye is maintained by the blood–retinal barrier’s passive physical sequestration via tight junctions and the retinal pigment epithelium. The protective microenvironment of the eye is immunosuppressive and it expresses substances such as Qa-1, Fas ligand, and indolamine dioxidase (IDO) which function to prevent a damaging inflammatory reaction to ocular tissues. The immunosuppressive environment is also influenced by the aqueous humor which dampens the activity of many immune responses including nitric oxide production by macrophages, complement activation, neutrophil activation, lymphocyte proliferation, and NK cell activity. Treg cells are also involved in the immune privilege of the eye through anterior chamber-associated immune deviation, in which injection of a foreign antigen into the anterior chamber of the eye causes an antigen-dependent down regulation of delayed-type hypersensitivity. Overall, these mechanisms create an environment that is sheltered from potential immune cell-induced injury.

Adaptive immunity and uveitis

Typically, uveitis is classified by the affected anatomical part of the eye (e.g., anterior uveitis, intermediate uveitis, posterior uveitis and panuveitis). Often the cause of uveitis is idiopathic, but sometimes an infectious cause (e.g., toxoplasmosis, tuberculosis, onchocerciasis, cysticercosis, leprosy and leptospirosis) can be responsible for this disease. Non-infectious uveitis is immune mediated and can be limited to the eye (e.g., sympathetic ophthalmia and birdshot retinochoroidopathy) or part of a broader systemic disease (e.g., sero-negative HLA-B27-positive spondyloarthropathies, juvenile idiopathic arthritis, sarcoidosis, multiple sclerosis, inflammatory bowel disease, tubulointerstitial nephritis, Behçet disease, and Vogt–Koyanagi–Harada syndrome). Ongoing research proposes that noninfectious uveitis may be an autoimmune condition through breakdown of self-tolerance and mobilization of autoreactive effector cells. However, there are some theories in the field suggesting some cases of idiopathic immune-mediated uveitis might be the result of reactivatable infectious agents concealed in ocular tissue rather than true autoimmunity. Nevertheless, autoimmune pathogenesis is generally accepted as a contributing factor in uveitis. Support for the autoimmune theory of uveitis is provided by the increased genetic susceptibility of people with certain HLA phenotypes, as HLA genes have long been linked to autoimmunity. In addition, autoimmune conditions are characterized by autoreactive T cells targeting self-antigens, evidence of which has been demonstrated in patients with noninfectious uveitis with uveal melanin, retinal arrestin, and inter-photoreceptor retinoid binding protein (IRBP). The experimental autoimmune uveitis (EAU) mouse model of posterior uveitis has demonstrated reduced inflammation through anti-CD3-mediated T cell suppression. Interestingly, another study that used an anti-CD3 antibody saw a decrease activation of effector T cells but enhanced activation of Treg cells. The autoreactive T cells responsible for autoimmune pathology were thought to be Th1 CD4 + T cells, but more recent studies have indicated both Th1 and Th17 cells can contribute. Most research implicates both Th1 and Th17 in uveitis pathology, but other subsets may also be involved as well, such as a small subset of T cells known as γδ T cells. Some studies have also reported the possibility of autoreactive CD8 + T cells involvement in uveitis. It is also possible that the etiology may vary between the different conditions and the stages of uveitis. For example, in Behçet’s uveitis there is a greater number of CD8 + T cell in the aqueous humor, but in sarcoid uveitis the CD4 + /CD8 + ratio was increased. These discrepancies suggest a possible difference in the pathogenesis between uveitis etiologies which could also affect their treatment approaches. There is still a lot to be done to fully clarify the role of CD8 + T cells in uveitis pathology, but there is mounting evidence that CD8 + T cells participate in autoimmune disease, making it plausible that they contribute significantly in uveitis pathology. Despite some remaining ambiguity, there is substantial support that Th1 cells and Th17 cells are implicated in autoimmune pathology. The specific role of each T cell subset in uveitis requires additional research that will fill in the gaps in our knowledge.

Most of the studies have focused on the roles of T cells, but B lymphocytes also likely play roles in uveitis. B lymphocytes may promote an inflammatory environment as well as promote T cell survival. For example, depletion of B lymphocytes by rituximab and other monoclonal antibodies treatment in uveitis provides positive outcomes. In contrast, some studies also have shown protective effects of B lymphocytes. For example, B lymphocytes suppressed intraocular inflammation and helped expand protective Treg cells in a mouse model. Additionally, loss of a transcription factor in B cells caused suppression of both B regulatory and T regulatory cells, which resulted in worsening of the disease. This suggests that certain B cell subsets may be contributing to uveitis pathology, while others may be protective.

Studies have shown that regulatory T (Treg) cells in uveitis have the ability to modulate inflammation and downregulate effector immune functions. The unregulated inflammation seen in uveitis suggests aberrant activation or a breakdown in proper Treg cells functionality or number. This idea was supported by a study done by Muhammad et al. that showed reduced ability to induce Treg cells in the experimental autoimmune uveoretinitis model. In addition, a reduction in Treg cells has been shown in patients with active uveitis and Behçet’s disease before an ocular attack in peripheral blood samples. Dysregulation of Treg cells has also been shown as a contributing factor for disease recurrence in recurrent experimental autoimmune uveitis. Additionally, in a mouse model of experimental autoimmune uveitis adoptive transfer of Treg cells has been shown to suppress disease progression. This idea is further supported by a study that claims a shift away from an inflammatory T cell phenotype in favor of Treg cells help mediate disease resolution. Silver et al. also implicate Treg cells in the resolution and remission of uveitis pathology, although they claim Treg cells functionality is not impaired under pathologic condition. This is a direct contradiction of what Ke et al. state when they claim that dysregulation and improper function of Treg cells contribute to disease reoccurrence. Nevertheless, despite this discrepancy in whether Treg cells are decreased in number only or also in functionality, promoting the proliferation of Treg cells results in the suppression of pathology. These studies implicate Treg cells dysfunction during the development of uveitis. Moreover, a deficiency of Treg cells (e.g., function, numbers) may play a central role in disease pathogenesis. More research is needed to clarify how the population of Treg cells changed during the progression of uveitis.

Adaptive immunity and diabetic retinopathy

Diabetic retinopathy is one of the leading causes of blindness in human between the ages 27 and 75, and its estimated prevalence is 90% for patients who have had diabetes for over 20 years. Chronic poor glucose control along with diabetes can lead to vascular complications such as macular edema, neovascularization, and microaneurysms which result in the loss of central vision in diabetic retinopathy patients. As the incidence of diabetes continues to rise, the number of people suffering from diabetic retinopathy is expected to rise as well. Many factors contribute to the development of diabetic retinopathy, but this perspective review will provide limited information for the role of T cells in the diabetic retinopathy.

Inflammation has been linked to obesity and metabolic disorders such as diabetes. Many pro-inflammatory cytokines have been shown to be elevated in the vitreous humor of patients with diabetic retinopathy including TNF-α, IL-8 and MCP-1, IL-6, IL-26 and IL-1β. Studies have also shown that more Th1-dependent pro-inflammatory cytokines are secreted in diabetic retinopathy, suggesting an imbalance of lymphocytes. An important part of diabetic retinopathy pathology is blood vessel angiogenesis which is promoted by vascular endothelial growth factor (VEGF). However, studies have shown that the Th1/Th2 ratio is an independent predictor of VEGF plasma levels in diabetic retinopathy. Other studies suggest that Th17 cell-dependent IL-17 may be associated with the inflammation observed in diabetic retinopathy. IL-17A has been shown to be an important detrimental cytokine in the progression of diabetic retinopathy. Studies have also shown that Th17 cells can infiltrate the retina in a diabetic retinopathy mouse model. Moreover, elevated levels of IL-17 have been identified in the plasma, vitreous, and aqueous humor, of diabetic retinopathy patients. However, conflicting data exist on the level of IL-17 in the serum of diabetic retinopathy patients because studies have also shown a negative association with IL-17 and diabetic retinopathy.

The overwhelming inflammation seen in diabetic retinopathy may be due to an imbalance of Treg cells. For example, studies have shown decreased numbers of Treg cells in type II diabetes and diabetic retinopathy patients. Treg cells have also been shown to be beneficial in repairing abnormal angiogenesis in diabetic retinopathy. In addition to the disturbance in the homeostasis of effector T cells and the population of Treg cells, Treg cells functions could also be altered by the surrounding environment. For instance, Treg cells may be unable to properly suppress inflammation in diabetic retinopathy due to elevated insulin levels. Treg cells have been shown to have reduced suppressive capacity in type II diabetes mellitus patients. Additional studies are required to clearly understand the neuroprotective role of Treg cells in diabetic retinopathy.

Adaptive immunity and age-related macular degeneration

Age-related macular degeneration (AMD) is a progressive disease-causing degeneration of the macula and is the leading cause of blindness among the elderly population in developed countries. Two different pathologic components contribute to vision loss in AMD: focal atrophy of the retinal pigment epithelium (RPE) and photoreceptor loss (“dry” AMD) or choroidal neovascularization (“wet” AMD). Typically, dry AMD is a precursor for wet AMD, but not all patients will experience both. In dry AMD, there is a gradual expansion of the atrophic lesions and a slow progressive vision loss. In wet AMD, the new blood vessels leak leading to edema, retinal damage, and can cause a rapid loss of visual acuity. Currently, there is no approved drug therapy to treat dry macular degeneration, though there are many ongoing clinical trials to address this problem. Some clinical progress has been made to treat wet AMD, such as anti-VEGF therapy that targets VEGF, an important growth factor that facilitates angiogenesis. However, anti-VEGF therapy only delays disease progression and upon treatment cessation relapse is a common problem. An important component of AMD is persistent inflammation. Elevated levels of complement proteins have been detected in the blood samples of AMD patients, suggesting some sort of complement dysfunction may be contributing to the disease. The current understanding of AMD is that local complement dysregulation is involved in the disease pathogenesis. One component of complement called complement factor H (CFH) is an important inhibitor of the alternative pathway of complement, and CFH polymorphisms have been linked to an increased risk of AMD development. Despite the abundance of genetic evidence linking complement to AMD, the exact role of how complement may be involved is still not clear.

Studies in an AMD mouse model have shown that T cells can contribute to AMD pathogenesis. Patients with neovascularization AMD were also shown to have higher systemic lymphocyte counts, suggesting that lymphocytes may play an active role in initiating the neovascularization seen in AMD.. Several studies found that the neutrophil-to-lymphocyte ratio (NLR), which are thought to be a marker of both inflammation and angiogenesis, were elevated in wet AMD. These studies suggest that immune cells may be dysfunctional in neovascular AMD, however, the clinical relevance remains unclear. In addition, increased recruitment of T cells in AMD has also been shown. Studies have also shown dysfunction or senescence of the immune system in the context of aging and neurodegenerative disease through the creation of a chronic state of low-grade inflammation referred to as “inflammaging”. This state of immune senescence has been implicated in AMD in which T cells are likely involved. Additionally, several studies have shown an increased proportion of aged T cells in AMD patients, suggesting that immune dysfunction may play a role in disease pathogenesis. Dysregulation of follicular T cells has also been reported in AMD. The idea of T cells dysregulation is further supported by a study showing alterations in systemic Th1 lymphocyte profiles in AMD patients. More specifically, studies have shown that IL-17 may be an important part of AMD disease development since reducing IL-17 levels decreased the amount of choroidal neovascularization. However, unlike other diseases previously discussed in this review, the main source of IL-17 in AMD may not be from Th17 cells, but instead from γδ T cells. These IL-17 producing γδ T cells have been shown to infiltrate the eye in a mouse model of choroidal neovascularization (CNV). Notably, IL-17 + cells have also been identified near areas of RPE atrophy. Another mouse model study showed that Th2 cytokines, mainly IL-4, helped to decrease neovascularization in the disease process. This supports the overall theory that an imbalance in the pro/anti-inflammatory phenotypes helps to drive AMD. Limited data have shown an increase in Th17 and Th1 cells in AMD patients, whereas another study has shown a decrease in Th1 cells and no significant changes in Th17 cells. Interestingly, one study found that decreased levels of CD4 + T cells correlated with the absence of subretinal fibrosis in AMD. Overall, more studies are needed to better understand the role of adaptive immune cells in AMD.

Limited literature exists for the involvement of B lymphocytes in AMD, but anti-retinal antibodies have been identified in AMD patients. It remains in question whether they are a consequence of disease-related damage or a contributory factor for the disease development. In contrast, studies have also shown no difference in the number of circulating B lymphocytes in AMD patients when compared with healthy subjects, which does not rule out B lymphocytes involvement in AMD pathology because antibody production by B lymphocytes could still have a contributory effect. Studies have also suggested that autoantibodies could be used as biomarkers for future disease progression and prognostication. Another study found elevated levels of IL-17 correlated with response to anti-VEGF therapy. Identification of a biomarker could have great clinical significance in AMD treatment, however more work is needed in this area.

Retina repair and reduced angiogenesis were observed through adoptive transfer of Treg cells and Treg cells expansion. Currently, not many studies have looked at the role of Treg cells in AMD. One study did not find changes in the number of systemic Treg cells in AMD. Like effector T cells and B cells, it is again possible that Treg cells dysfunction may play larger roles than Treg cells number. Treg cells are a promising candidate to study in inflammatory diseases, and they may be implicated in AMD, though more research is needed.

Adaptive immunity and glaucoma

Glaucoma is the second leading cause of blindness worldwide in which retinal ganglion cells (RGCs) die slowly and progressively over a prolonged period of time. Glaucoma is now considered to be a multifactorial disease and molecular mechanisms involved in RGC death are complex and poorly understood. The primary risk factor for developing glaucoma is elevated intraocular pressure (IOP), but the pathophysiology of the disease is more complicated. There is currently no known cure for glaucoma and treatment focuses on reducing IOP. Unfortunately, some patients under IOP-lowering therapy still see progression of the disease, which clearly indicates that better therapeutic options are needed to fully cure the disease. Studies have shown that multiple factors play key roles in RGC degeneration including activation of caspases, apoptosis, oxidative stress, ischemia and hypoxia, epigenetic changes, Crosson 2010 #975,, alteration in the levels of pro-inflammatory cytokines, and deprivation of neurotrophic factors. There is another opinion with limited evidence, which suggests the neurodegeneration observed in glaucoma could be vascular. This theory suggests that hemodynamic alterations and changes in local blood flow may cause unstable ocular perfusion to the optic nerve. Recently, studies have also shown participation of T cells in glaucoma pathology. A study has shown that elevated IOP allowed for T cell infiltration of the retina and led to continued degeneration of RGCs after IOP was returned to a normal level.

The innate immune system has long been tied to glaucoma through the action of glial cells and oxidative stress, but recent evidence provides additional support for the involvement of the adaptive immune system in glaucoma pathology. Earlier studies have shown that glaucoma could be critically tied to the immune system because resistance of RGC death was shown to be correlated with immune potency. This study suggested that immune dysfunction may be a prerequisite for developing glaucoma and would explain the disparities in degree of disease progression among patients treated with ocular hypertensive agents. Afterwards, numerous studies have shown the presence of autoantibodies to retinal and optic nerve proteins in the serum, retina, and aqueous humor of glaucoma patients. Studies have also shown the presence of autoantibodies to heat shock proteins in glaucoma. Heat shock proteins are a large family of molecular chaperones that can be upregulated in times of stress, but also have significant potential to induce molecular mimicry resulting in the creation of autoantibodies to host proteins. In glaucoma, elevated levels of heat shock proteins such as HSP72, HSP60, and HSP27, have been reported, some of which may help facilitate RGC death. Introduction of heat shock proteins to rats through immunization can induce glaucomatous injury, but other studies have shown that induction of heat shock proteins can provide neuroprotection for RGCs. Overall, the role of autoantibodies and heat shock proteins in glaucoma remains unclear. It is not clear if they are involved in glaucoma pathology directly, indirectly, or play a role in protective autoimmunity.

The involvement of T cells in glaucoma pathology remains in question, but we believe that T cell subsets, specifically the T effector/Treg cells homoeostasis, play a critical role in determining the fate of RGCs during glaucoma progression. Additionally, studies have shown an adoptive transfer of lymphocytes from glaucomatous mice into healthy mice stimulated RGC loss. This causative effect suggests that adaptive immune dysfunction plays a direct role in the pathophysiology of glaucoma. Studies have shown that CD4 + T cells facilitate RGC death in an acute ischemia/reperfusion injury model. An imbalance in Treg cells/Th17 cells in experimental autoimmune optic neuritis (EAON) has been shown, which shares key characteristics of glaucoma pathology. Recent studies have also shown that transient elevation of IOP can cause T cells infiltration to the retina, leading to RGC degeneration. However, the role of Treg cells in glaucoma remains fully unexplored. The authors’ perspective in this regard is “enhanced neuroinflammation during glaucoma could be due to low number and/or function of Treg cells”. In other systems, unchecked inflammation has been attributed due to improper functioning of Treg cells. Adoptive transfer of Treg cells has shown promise in treating inflammatory conditions such as enteritis and multiple sclerosis suggesting it may prove an effective therapeutic option in glaucoma. If under glaucomatous condition Treg cells are unable to differentiate, adoptive transfer of Treg cells may ameliorate the T cell imbalance and decrease inflammation. More work is needed in this field to better understand the involvement of T cells in glaucoma progression.

Conclusions

We provided a brief overview of adaptive immunity, autoimmunity, and tolerance and related them to neurodegenerative and ocular diseases. This perspective review article aims to emphasize the significance of adaptive immunity concerning neurodegenerative conditions and highlight the gaps in the field. It also highlights the pathological and neuroprotective roles of different subsets of lymphocytes in numerous neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and several ocular diseases. Figure 1 provides a framework of potential contributing factors to neurodegenerative diseases. Although the etiology of each neurodegenerative disease is different and complex, a few common players that may have crucial roles in the pathology have been shown. These factors include neuroinflammation, epigenetic changes, ischemia/hypoxia, oxidative stress, hemodynamic alterations, and changes in the immune cells. The focus of this perspective review is to provide information for the role of immune cells (e.g., effector T and Treg cells) in neurodegenerative diseases. Based on the literature in non-ocular and ocular neurodegenerative diseases, we provided our perspective that: (1) the number of effector T cells may be increased under ocular pathologies such as uveitis, diabetic retinopathy, AMD, and glaucoma. Elevated T cells can subsequently enhance the secretion of pro-inflammatory cytokines and expedite retinal degeneration similar to other neurodegenerative diseases, and (2) Treg cells are deficient in function and/or number rendering them unable to sufficiently regulate the function of effector T cells in ocular pathologies as seen in other neurodegenerative diseases. Evidence of lymphocyte involvement in ocular pathologies is promising and there is a vital need for more research in this field. We conclude that T cell subsets homeostasis is critical for the maintenance and regulation of neuroinflammation. If the homeostasis is lost and the balance of specialized subsets of immune cells breaks down, damage to the host’s tissues can lead to pathological conditions. The inability to yet discover a neuroprotective therapy for ocular pathologies (e.g., uveitis, diabetic retinopathy, AMD, and glaucoma) it is highly desirable to target immune cells for future research.

Based on the literature provided in this perspective review article, we believe that in ocular neurodegenerative diseases, there may be an imbalance in the number of effector T cells as well as the number and or function of Treg cells, which might contribute to a pro-inflammatory state and facilitate neuronal death in such ocular diseases (e.g., uveitis, diabetic retinopathy, AMD, and glaucoma). This area of research is underdeveloped, hence more studies are needed to clearly understand how T cell subsets and dysfunction may play a role in developing ocular neurodegenerative diseases.

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    Duddy M, Niino M, Adatia F, Hebert S, Freedman M, Atkins H, Kim HJ, Bar-Or A. Distinct effector cytokine profiles of memory and naive human B cell subsets and implication in multiple sclerosis. J Immunol. 2007;178(10):6092-6099.

    Not in our library10.4049/jimmunol.178.10.6092

  86. 86.

    Duddy ME, Alter A, Bar-Or A. Distinct profiles of human B cell effector cytokines: a role in immune regulation? J Immunol. 2004;172(6):3422-3427.

    Not in our library10.4049/jimmunol.172.6.3422

  87. 87.

    Duffy SS, Keating BA, Moalem-Taylor G. Adoptive transfer of regulatory T cells as a promising immunotherapy for the treatment of multiple sclerosis. Front Neurosci. 2019;13:1107.

    Not in our library10.3389/fnins.2019.01107

  88. 88.

    Edwards AO, Ritter R, Abel KJ, Manning A, Panhuysen C, Farrer LA. Complement factor H polymorphism and age-related macular degeneration. Science. 2005;308(5720):421-424.

    Not in our library10.1126/science.1110189

  89. 89.

    Faber C, Singh A, Kruger Falk M, Juel HB, Sorensen TL, Nissen MH. Age-related macular degeneration is associated with increased proportion of CD56(+) T cells in peripheral blood. Ophthalmology. 2013;120(11):2310-2316.

    Not in our library10.1016/j.ophtha.2013.04.014

  90. 90.
  91. 91.

    Farber DL, Yudanin NA, Restifo NP. Human memory T cells: generation, compartmentalization and homeostasis. Nat Rev Immunol. 2014;14(1):24-35.

    Not in our library10.1038/nri3567

  92. 92.

    Feger U, Luther C, Poeschel S, Melms A, Tolosa E, Wiendl H. Increased frequency of CD4+ CD25+ regulatory T cells in the cerebrospinal fluid but not in the blood of multiple sclerosis patients. Clin Exp Immunol. 2007;147(3):412-418.

    Not in our library10.1111/j.1365-2249.2006.03271.x

  93. 93.

    Feng S, Yu H, Yu Y, Geng Y, Li D, Yang C, Lv Q, Lu L, Liu T, Li G, Yuan L. Levels of inflammatory cytokines IL-1beta, IL-6, IL-8, IL-17A, and TNF-alpha in aqueous humour of patients with diabetic retinopathy. J Diabetes Res. 2018;2018:8546423.

    Not in our library10.1155/2018/8546423

  94. 94.

    Ferrero J, Williams L, Stella H, Leitermann K, Mikulskis A, O'Gorman J, Sevigny J. First-in-human, double-blind, placebo-controlled, single-dose escalation study of aducanumab (BIIB037) in mild-to-moderate Alzheimer's disease. Alzheimers Dement (N Y). 2016;2(3):169-176.

    Not in our library10.1016/j.trci.2016.06.002

  95. 95.

    Ferretti MT, Merlini M, Spani C, Gericke C, Schweizer N, Enzmann G, Engelhardt B, Kulic L, Suter T, Nitsch RM. T-cell brain infiltration and immature antigen-presenting cells in transgenic models of Alzheimer's disease-like cerebral amyloidosis. Brain Behav Immun. 2016;54:211-225.

    Not in our library10.1016/j.bbi.2016.02.009

  96. 96.

    Flammer J, Orgul S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, Renard JP, Stefansson E. The impact of ocular blood flow in glaucoma. Prog Retin Eye Res. 2002;21(4):359-393.

    Not in our library10.1016/s1350-9462(02)00008-3

  97. 97.

    Fletcher JM, Lalor SJ, Sweeney CM, Tubridy N, Mills KH. T cells in multiple sclerosis and experimental autoimmune encephalomyelitis. Clin Exp Immunol. 2010;162(1):1-11.

    Not in our library10.1111/j.1365-2249.2010.04143.x

  98. 98.

    Forrester JV, Kuffova L, Dick AD. Autoimmunity, autoinflammation, and infection in uveitis. Am J Ophthalmol. 2018;189:77-85.

    Not in our library10.1016/j.ajo.2018.02.019

  99. 99.
  100. 100.

    Foxman EF, Zhang M, Hurst SD, Muchamuel T, Shen D, Wawrousek EF, Chan CC, Gery I. Inflammatory mediators in uveitis: differential induction of cytokines and chemokines in Th1- versus Th2-mediated ocular inflammation. J Immunol. 2002;168(5):2483-2492.

    Not in our library10.4049/jimmunol.168.5.2483

  101. 101.

    Franceschi C, Capri M, Monti D, Giunta S, Olivieri F, Sevini F, Panourgia MP, Invidia L, Celani L, Scurti M, Cevenini E, Castellani GC, Salvioli S. Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans. Mech Ageing Dev. 2007;128(1):92-105.

    Not in our library10.1016/j.mad.2006.11.016

  102. 102.

    Frischer JM, Bramow S, Dal-Bianco A, Lucchinetti CF, Rauschka H, Schmidbauer M, Laursen H, Sorensen PS, Lassmann H. The relation between inflammation and neurodegeneration in multiple sclerosis brains. Brain. 2009;132(Pt 5):1175-1189.

    Not in our library10.1093/brain/awp070

  103. 103.
  104. 104.

    Gate D, Saligrama N, Leventhal O, Yang AC, Unger MS, Middeldorp J, Chen K, Lehallier B, Channappa D, De Los Santos MB, McBride A, Pluvinage J, Elahi F, Tam GK, Kim Y, Greicius M, Wagner AD, Aigner L, Galasko DR, Davis MM, Wyss-Coray T. Clonally expanded CD8 T cells patrol the cerebrospinal fluid in Alzheimer’s disease. Nature. 2020;577(7790):399-404.

    Not in our library10.1038/s41586-019-1895-7

  105. 105.

    Gauthier AC, Liu J. Epigenetics and signaling pathways in glaucoma. Biomed Res Int. 2017;2017:5712341.

    Not in our library10.1155/2017/5712341

  106. 106.

    Geem D, Harusato A, Flannigan K, Denning TL. Harnessing regulatory T cells for the treatment of inflammatory bowel disease. Inflamm Bowel Dis. 2015;21(6):1409-1418.

    Not in our library10.1097/mib.0000000000000343

  107. 107.

    Geyer O, Levo Y. Glaucoma is an autoimmune disease. Autoimmun Rev. 2020;102535.

    Not in our library10.1016/j.autrev.2020.102535

  108. 108.

    Gilbert RM, Zhang X, Sampson RD, Ehrenstein MR, Nguyen DX, Chaudhry M, Mein C, Mahmud N, Galatowicz G, Tomkins-Netzer O, Calder VL, Lightman S. Clinical remission of sight-threatening non-infectious uveitis is characterized by an upregulation of peripheral T-regulatory cell polarized towards T-bet and TIGIT. Front Immunol. 2018;9:907.

    Not in our library10.3389/fimmu.2018.00907

  109. 109.

    Goldblum D, Mittag T. Prospects for relevant glaucoma models with retinal ganglion cell damage in the rodent eye. Vision Res. 2002;42(4):471-478.

    Not in our library10.1016/s0042-6989(01)00194-8

  110. 110.
  111. 111.

    Goslings WR, Prodeus AP, Streilein JW, Carroll MC, Jager MJ, Taylor AW. A small molecular weight factor in aqueous humor acts on C1q to prevent antibody-dependent complement activation. Invest Ophthalmol Vis Sci. 1998;39(6):989-995.

    Not in our library

  112. 112.
  113. 113.

    Gramlich OW, Ding QJ, Zhu W, Cook A, Anderson MG, Kuehn MH. Adoptive transfer of immune cells from glaucomatous mice provokes retinal ganglion cell loss in recipients. Acta Neuropathol Commun. 2015;3:56.

    Not in our library10.1186/s40478-015-0234-y

  114. 114.

    Gruden MA, Sewell RD, Yanamandra K, Davidova TV, Kucheryanu VG, Bocharov EV, Bocharova OA, Polyschuk VV, Sherstnev VV, Morozova-Roche LA. Immunoprotection against toxic biomarkers is retained during Parkinson’s disease progression. J Neuroimmunol. 2011;233(1–2):221-227.

    Not in our library10.1016/j.jneuroim.2010.12.001

  115. 115.

    Guedes MC, Borrego LM, Proenca RD. Roles of interleukin-17 in uveitis. Indian J Ophthalmol. 2016;64(9):628-634.

    Not in our library10.4103/0301-4738.194339

  116. 116.

    Guo L, Moss SE, Alexander RA, Ali RR, Fitzke FW, Cordeiro MF. Retinal ganglion cell apoptosis in glaucoma is related to intraocular pressure and IOP-induced effects on extracellular matrix. Invest Ophthalmol Vis Sci. 2005;46(1):175-182.

    Not in our library10.1167/iovs.04-0832

  117. 117.

    Guo Z, Wang G, Lv Y, Wan YY, Zheng J. Inhibition of Cdk8/Cdk19 activity promotes treg cell differentiation and suppresses autoimmune diseases. Front Immunol. 2019;10:1988.

    Not in our library10.3389/fimmu.2019.01988

  118. 118.

    Gurne DH, Tso MO, Edward DP, Ripps H. Antiretinal antibodies in serum of patients with age-related macular degeneration. Ophthalmology. 1991;98(5):602-607.

    Not in our library10.1016/s0161-6420(91)32252-8

  119. 119.

    Gustavsson C, Agardh CD, Agardh E. Profile of intraocular tumour necrosis factor-alpha and interleukin-6 in diabetic subjects with different degrees of diabetic retinopathy. Acta Ophthalmol. 2013;91(5):445-452.

    Not in our library10.1111/j.1755-3768.2012.02430.x

  120. 120.

    Haas J, Hug A, Viehover A, Fritzsching B, Falk CS, Filser A, Vetter T, Milkova L, Korporal M, Fritz B, Storch-Hagenlocher B, Krammer PH, Suri-Payer E, Wildemann B. Reduced suppressive effect of CD4+CD25high regulatory T cells on the T cell immune response against myelin oligodendrocyte glycoprotein in patients with multiple sclerosis. Eur J Immunol. 2005;35(11):3343-3352.

    Not in our library10.1002/eji.200526065

  121. 121.

    Halle S, Halle O, Forster R. Mechanisms and dynamics of T cell-mediated cytotoxicity in vivo. Trends Immunol. 2017;38(6):432-443.

    Not in our library10.1016/j.it.2017.04.002

  122. 122.

    Hammers CM, Stanley JR. Mechanisms of disease: pemphigus and bullous pemphigoid. Annu Rev Pathol. 2016;11:175-197.

    Not in our library10.1146/annurev-pathol-012615-044313

  123. 123.

    Han JM, Patterson SJ, Speck M, Ehses JA, Levings MK. Insulin inhibits IL-10-mediated regulatory T cell function: implications for obesity. J Immunol. 2014;192(2):623-629.

    Not in our library10.4049/jimmunol.1302181

  124. 124.

    Hang H, Yuan S, Yang Q, Yuan D, Liu Q. Multiplex bead array assay of plasma cytokines in type 2 diabetes mellitus with diabetic retinopathy. Mol Vis. 2014;20:1137-1145.

    Not in our library

  125. 125.

    Hasegawa E, Sonoda KH, Shichita T, Morita R, Sekiya T, Kimura A, Oshima Y, Takeda A, Yoshimura T, Yoshida S, Ishibashi T, Yoshimura A. IL-23-independent induction of IL-17 from gammadeltaT cells and innate lymphoid cells promotes experimental intraocular neovascularization. J Immunol. 2013;190(4):1778-1787.

    Not in our library10.4049/jimmunol.1202495

  126. 126.

    Hecker LA, Edwards AO, Ryu E, Tosakulwong N, Baratz KH, Brown WL, Charbel Issa P, Scholl HP, Pollok-Kopp B, Schmid-Kubista KE, Bailey KR, Oppermann M. Genetic control of the alternative pathway of complement in humans and age-related macular degeneration. Hum Mol Genet. 2010;19(1):209-215.

    Not in our library10.1093/hmg/ddp472

  127. 127.

    Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M, G. Early Manifest Glaucoma Trial. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120(10):1268-1279.

    Not in our library10.1001/archopht.120.10.1268

  128. 128.

    Heiligenhaus A, Miserocchi E, Heinz C, Gerloni V, Kotaniemi K. Treatment of severe uveitis associated with juvenile idiopathic arthritis with anti-CD20 monoclonal antibody (rituximab). Rheumatology (Oxford). 2011;50(8):1390-1394.

    Not in our library10.1093/rheumatology/ker107

  129. 129.

    Hemmer B, Kerschensteiner M, Korn T. Role of the innate and adaptive immune responses in the course of multiple sclerosis. Lancet Neurol. 2015;14(4):406-419.

    Not in our library10.1016/s1474-4422(14)70305-9

  130. 130.

    Hernandez C, Segura RM, Fonollosa A, Carrasco E, Francisco G, Simo R. Interleukin-8, monocyte chemoattractant protein-1 and IL-10 in the vitreous fluid of patients with proliferative diabetic retinopathy. Diabet Med. 2005;22(6):719-722.

    Not in our library10.1111/j.1464-5491.2005.01538.x

  131. 131.

    Hirosue S, Dubrot J. Modes of antigen presentation by lymph node stromal cells and their immunological implications. Front Immunol. 2015;6:446.

    Not in our library10.3389/fimmu.2015.00446

  132. 132.

    Hirsch EC, Hunot S. Neuroinflammation in Parkinson’s disease: a target for neuroprotection? Lancet Neurol. 2009;8(4):382-397.

    Not in our library10.1016/s1474-4422(09)70062-6

  133. 133.

    Horai R, Caspi RR. Cytokines in autoimmune uveitis. J Interferon Cytokine Res. 2011;31(10):733-744.

    Not in our library10.1089/jir.2011.0042

  134. 134.

    Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006;444(7121):860-867.

    Not in our library10.1038/nature05485

  135. 135.
  136. 136.

    Huan J, Culbertson N, Spencer L, Bartholomew R, Burrows GG, Chou YK, Bourdette D, Ziegler SF, Offner H, Vandenbark AA. Decreased FOXP3 levels in multiple sclerosis patients. J Neurosci Res. 2005;81(1):45-52.

    Not in our library10.1002/jnr.20522

  137. 137.

    Huang P, Huo Y, Lou LX, Li H, Barnstable CJ, Zhang C, Zhang SS. CD4 positive T helper cells contribute to retinal ganglion cell death in mouse model of ischemia reperfusion injury. Exp Eye Res. 2013;115:131-139.

    Not in our library10.1016/j.exer.2013.06.015

  138. 138.

    Huang Y, Hu H, Liu L, Ye J, Wang Z, Que B, Liu W, Shi Y, Zeng T, Shi L, Ji Q, Chang C, Lin Y. Interleukin-12p35 deficiency reverses the Th1/Th2 imbalance, aggravates the Th17/Treg imbalance, and ameliorates atherosclerosis in ApoE-/- Mice. Mediators Inflamm. 2019;2019:3152040.

    Not in our library10.1155/2019/3152040

  139. 139.

    Huang Y, Liu Z, Cao BB, Qiu YH, Peng YP. Treg cells attenuate neuroinflammation and protect neurons in a mouse model of Parkinson’s disease. J Neuroimmune Pharmacol. 2020;15(2):224-237.

    Not in our library10.1007/s11481-019-09888-5

  140. 140.

    Hunot S, Boissiere F, Faucheux B, Brugg B, Mouatt-Prigent A, Agid Y, Hirsch EC. Nitric oxide synthase and neuronal vulnerability in Parkinson’s disease. Neuroscience. 1996;72(2):355-363.

    Not in our library10.1016/0306-4522(95)00578-1

  141. 141.

    Husain S, Abdul Y, Crosson CE. Preservation of retina ganglion cell function by morphine in a chronic ocular-hypertensive rat model. Invest Ophthalmol Vis Sci. 2012;53(7):4289-4298.

    Not in our library10.1167/iovs.12-9467

  142. 142.

    Husain S, Abdul Y, Potter DE. Non-analgesic effects of opioids: neuroprotection in the retina. Curr Pharm Des. 2012;18(37):6101-6108.

    Not in our library10.2174/138161212803582441

  143. 143.
  144. 144.

    Husain S, Potter DE, Crosson CE. Opioid receptor-activation: retina protected from ischemic injury. Invest Ophthalmol Vis Sci. 2009;50(8):3853-3859.

    Not in our library10.1167/iovs.08-2907

  145. 145.

    Husain S, Zaidi SAH, Singh S, Guzman W, Mehrotra S. Reduction of neuroinflammation by delta-opioids via STAT3-dependent pathway in chronic glaucoma model. Front Pharmacol. 2021;12:601404.

    Not in our library10.3389/fphar.2021.601404

  146. 146.
  147. 147.

    Ilhan N, Daglioglu MC, Ilhan O, Coskun M, Tuzcu EA, Kahraman H, Keskin U. Assessment of neutrophil/lymphocyte ratio in patients with age-related macular degeneration. Ocul Immunol Inflamm. 2015;23(4):287-290.

    Not in our library10.3109/09273948.2014.921715

  148. 148.

    Ip B, Cilfone NA, Belkina AC, DeFuria J, Jagannathan-Bogdan M, Zhu M, Kuchibhatla R, McDonnell ME, Xiao Q, Kepler TB, Apovian CM, Lauffenburger DA, Nikolajczyk BS. Th17 cytokines differentiate obesity from obesity-associated type 2 diabetes and promote TNFalpha production. Obesity (Silver Spring). 2016;24(1):102-112.

    Not in our library10.1002/oby.21243

  149. 149.

    Ito JT, Cervilha DAB, Lourenco JD, Goncalves NG, Volpini RA, Caldini EG, Landman G, Lin CJ, Velosa APP, Teodoro WPR, Tiberio I, Mauad T, Martins MA, Macchione M, Lopes F. Th17/Treg imbalance in COPD progression: a temporal analysis using a CS-induced model. PLoS ONE. 2019;14(1):e0209351.

    Not in our library10.1371/journal.pone.0209351

  150. 150.

    Izzotti A, Bagnis A, Sacca SC. The role of oxidative stress in glaucoma. Mutat Res. 2006;612(2):105-114.

    Not in our library10.1016/j.mrrev.2005.11.001

  151. 151.

    Jagannathan-Bogdan M, McDonnell ME, Shin H, Rehman Q, Hasturk H, Apovian CM, Nikolajczyk BS. Elevated proinflammatory cytokine production by a skewed T cell compartment requires monocytes and promotes inflammation in type 2 diabetes. J Immunol. 2011;186(2):1162-1172.

    Not in our library10.4049/jimmunol.1002615

  152. 152.

    Janeway CA Jr TP, Walport M et al. Principles of innate and adaptive immunity. Immunobiology: The Immune System in Health and Disease 5th edition. New York, Garland Science. 2001.

    Not in our library

  153. 153.

    Janeway CA Jr TP, Walport M et al. T cell-mediated cytotoxicity. Immunobiology: The Immune System in Health and Disease. New York, Garland Science. 2001.

    Not in our library

  154. 154.

    Janeway CA Jr TP, Walport M et al. Antigen Recognition by T cells. Immunobiology: The Immune System in Health and Disease New York, Garland Science. 2001.

    Not in our library

  155. 155.

    Jelcic I, Al Nimer F, Wang J, Lentsch V, Planas R, Jelcic I, Madjovski A, Ruhrmann S, Faigle W, Frauenknecht K, Pinilla C, Santos R, Hammer C, Ortiz Y, Opitz L, Grönlund H, Rogler G, Boyman O, Reynolds R, Lutterotti A, Khademi M, Olsson T, Piehl F, Sospedra M, Martin R. Memory B cells activate brain-homing, autoreactive CD4(+) T cells in multiple sclerosis. Cell. 2018;175(1):85-100.e123.

    Not in our library10.1016/j.cell.2018.08.011

  156. 156.

    Jiang S, Kametani M, Chen DF. Adaptive immunity: new aspects of pathogenesis underlying neurodegeneration in glaucoma and optic neuropathy. Front Immunol. 2020;11:65.

    Not in our library10.3389/fimmu.2020.00065

  157. 157.

    Joachim SC, Bruns K, Lackner KJ, Pfeiffer N, Grus FH. Analysis of IgG antibody patterns against retinal antigens and antibodies to alpha-crystallin, GFAP, and alpha-enolase in sera of patients with “wet” age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 2007;245(5):619-626.

    Not in our library10.1007/s00417-006-0429-9

  158. 158.

    Joachim SC, Bruns K, Lackner KJ, Pfeiffer N, Grus FH. Antibodies to alpha B-crystallin, vimentin, and heat shock protein 70 in aqueous humor of patients with normal tension glaucoma and IgG antibody patterns against retinal antigen in aqueous humor. Curr Eye Res. 2007;32(6):501-509.

    Not in our library10.1080/02713680701375183

  159. 159.

    Joachim SC, Reichelt J, Berneiser S, Pfeiffer N, Grus FH. Sera of glaucoma patients show autoantibodies against myelin basic protein and complex autoantibody profiles against human optic nerve antigens. Graefes Arch Clin Exp Ophthalmol. 2008;246(4):573-580.

    Not in our library10.1007/s00417-007-0737-8

  160. 160.

    Joachim SC, Wuenschig D, Pfeiffer N, Grus FH. IgG antibody patterns in aqueous humor of patients with primary open angle glaucoma and pseudoexfoliation glaucoma. Mol Vis. 2007;13:1573-1579.

    Not in our library

  161. 161.

    Jones JL, Anderson JM, Phuah CL, Fox EJ, Selmaj K, Margolin D, Lake SL, Palmer J, Thompson SJ, Wilkins A, Webber DJ, Compston DA, Coles AJ. Improvement in disability after alemtuzumab treatment of multiple sclerosis is associated with neuroprotective autoimmunity. Brain. 2010;133(Pt 8):2232-2247.

    Not in our library10.1093/brain/awq176

  162. 162.

    Kaiser CJ, Ksander BR, Streilein JW. Inhibition of lymphocyte proliferation by aqueous humor. Reg Immunol. 1989;2(1):42-49.

    Not in our library

  163. 163.

    Kannarkat GT, Boss JM, Tansey MG. The role of innate and adaptive immunity in Parkinson’s disease. J Parkinsons Dis. 2013;3(4):493-514.

    Not in our library10.3233/jpd-130250

  164. 164.

    Kappos L, Hartung HP, Freedman MS, Boyko A, Radü EW, Mikol DD, Lamarine M, Hyvert Y, Freudensprung U, Plitz T, van Beek J. Atacicept in multiple sclerosis (ATAMS): a randomised, placebo-controlled, double-blind, phase 2 trial. Lancet Neurol. 2014;13(4):353-363.

    Not in our library10.1016/s1474-4422(14)70028-6

  165. 165.

    Karaaslan Z, Kahraman OT, Sanli E, Ergen HA, Ulusoy C, Bilgic B, Yilmaz V, Tuzun E, Hanagasi HA, Kucukali CI. Inflammation and regulatory T cell genes are differentially expressed in peripheral blood mononuclear cells of Parkinson's disease patients. Sci Rep. 2021;11(1):2316.

    Not in our library10.1038/s41598-021-81961-7

  166. 166.

    Kaul A, Gordon C, Crow MK, Touma Z, Urowitz MB, van Vollenhoven R, Ruiz-Irastorza G, Hughes G. Systemic lupus erythematosus. Nat Rev Dis Primers. 2016;2:16039.

    Not in our library10.1038/nrdp.2016.39

  167. 167.

    Ke Y, Jiang G, Sun D, Kaplan HJ, Shao H. Ocular regulatory T cells distinguish monophasic from recurrent autoimmune uveitis. Invest Ophthalmol Vis Sci. 2008;49(9):3999-4007.

    Not in our library10.1167/iovs.07-1468

  168. 168.

    Ke Y, Jiang G, Sun D, Kaplan HJ, Shao H. Anti-CD3 antibody ameliorates experimental autoimmune uveitis by inducing both IL-10 and TGF-beta dependent regulatory T cells. Clin Immunol. 2011;138(3):311-320.

    Not in our library10.1016/j.clim.2010.12.016

  169. 169.

    Kermer P, Klocker N, Labes M, Thomsen S, Srinivasan A, Bahr M. Activation of caspase-3 in axotomized rat retinal ganglion cells in vivo. FEBS Lett. 1999;453(3):361-364.

    Not in our library10.1016/s0014-5793(99)00747-4

  170. 170.

    Khanna S, Komati R, Eichenbaum DA, Hariprasad I, Ciulla TA, Hariprasad SM. Current and upcoming anti-VEGF therapies and dosing strategies for the treatment of neovascular AMD: a comparative review. BMJ Open Ophthalmol. 2019;4(1):e000398.

    Not in our library10.1136/bmjophth-2019-000398

  171. 171.
  172. 172.

    Kipnis J, Mizrahi T, Hauben E, Shaked I, Shevach E, Schwartz M. Neuroprotective autoimmunity: naturally occurring CD4+CD25+ regulatory T cells suppress the ability to withstand injury to the central nervous system. Proc Natl Acad Sci U S A. 2002;99(24):15620-15625.

    Not in our library10.1073/pnas.232565399

  173. 173.

    Knopman DS, Jones DT, Greicius MD. Failure to demonstrate efficacy of aducanumab: an analysis of the EMERGE and ENGAGE trials as reported by Biogen, December 2019. Alzheimers Dement. 2021;17(4):696-701.

    Not in our library10.1002/alz.12213

  174. 174.

    Koch S, Sopel N, Finotto S. Th9 and other IL-9-producing cells in allergic asthma. Semin Immunopathol. 2017;39(1):55-68.

    Not in our library10.1007/s00281-016-0601-1

  175. 175.

    Kohm AP, Carpentier PA, Anger HA, Miller SD. Cutting edge: CD4+CD25+ regulatory T cells suppress antigen-specific autoreactive immune responses and central nervous system inflammation during active experimental autoimmune encephalomyelitis. J Immunol. 2002;169(9):4712-4716.

    Not in our library10.4049/jimmunol.169.9.4712

  176. 176.

    Koonin EV, Krupovic M. Evolution of adaptive immunity from transposable elements combined with innate immune systems. Nat Rev Genet. 2015;16(3):184-192.

    Not in our library10.1038/nrg3859

  177. 177.

    Kroenke MA, Carlson TJ, Andjelkovic AV, Segal BM. IL-12- and IL-23-modulated T cells induce distinct types of EAE based on histology, CNS chemokine profile, and response to cytokine inhibition. J Exp Med. 2008;205(7):1535-1541.

    Not in our library10.1084/jem.20080159

  178. 178.

    Kumar BV, Connors TJ, Farber DL. Human T cell development, localization, and function throughout life. Immunity. 2018;48(2):202-213.

    Not in our library10.1016/j.immuni.2018.01.007

  179. 179.

    Kumar M, Putzki N, Limmroth V, Remus R, Lindemann M, Knop D, Mueller N, Hardt C, Kreuzfelder E, Grosse-Wilde H. CD4+CD25+FoxP3+ T lymphocytes fail to suppress myelin basic protein-induced proliferation in patients with multiple sclerosis. J Neuroimmunol. 2006;180(1–2):178-184.

    Not in our library10.1016/j.jneuroim.2006.08.003

  180. 180.

    Kumar P, Saini S, Khan S, Surendra Lele S, Prabhakar BS. Restoring self-tolerance in autoimmune diseases by enhancing regulatory T-cells. Cell Immunol. 2019;339:41-49.

    Not in our library10.1016/j.cellimm.2018.09.008

  181. 181.
  182. 182.

    La Paglia GMC, Leone MC, Lepri G, Vagelli R, Valentini E, Alunno A, Tani C. One year in review 2017: systemic lupus erythematosus. Clin Exp Rheumatol. 2017;35(4):551-561.

    Not in our library

  183. 183.

    Landowski M, Kelly U, Klingeborn M, Groelle M, Ding JD, Grigsby D, Bowes Rickman C. Human complement factor H Y402H polymorphism causes an age-related macular degeneration phenotype and lipoprotein dysregulation in mice. Proc Natl Acad Sci U S A. 2019;116(9):3703-3711.

    Not in our library10.1073/pnas.1814014116

  184. 184.

    Larbi A, Pawelec G, Witkowski JM, Schipper HM, Derhovanessian E, Goldeck D, Fulop T. Dramatic shifts in circulating CD4 but not CD8 T cell subsets in mild Alzheimer’s disease. J Alzheimers Dis. 2009;17(1):91-103.

    Not in our library10.3233/jad-2009-1015

  185. 185.

    Lardo S, Soesatyo MH, Juffrie J, Umniyati SR. The autoimmune mechanism in dengue hemorrhagic fever. Acta Med Indones. 2018;50(1):70-79.

    Not in our library

  186. 186.

    Laurent C, Dorothee G, Hunot S, Martin E, Monnet Y, Duchamp M, Dong Y, Legeron FP, Leboucher A, Burnouf S, Faivre E, Carvalho K, Caillierez R, Zommer N, Demeyer D, Jouy N, Sazdovitch V, Schraen-Maschke S, Delarasse C, Buee L, Blum D. Hippocampal T cell infiltration promotes neuroinflammation and cognitive decline in a mouse model of tauopathy. Brain. 2017;140(1):184-200.

    Not in our library10.1093/brain/aww270

  187. 187.

    Lechner J, Chen M, Hogg RE, Toth L, Silvestri G, Chakravarthy U, Xu H. Alterations in circulating immune cells in neovascular age-related macular degeneration. Sci Rep. 2015;5:16754.

    Not in our library10.1038/srep16754

  188. 188.

    Lechner J, O'Leary OE, Stitt AW. The pathology associated with diabetic retinopathy. Vision Res. 2017;139:7-14.

    Not in our library10.1016/j.visres.2017.04.003

  189. 189.
  190. 190.
  191. 191.
  192. 192.

    Legroux L, Arbour N. Multiple sclerosis and T lymphocytes: an entangled story. J Neuroimmune Pharmacol. 2015;10(4):528-546.

    Not in our library10.1007/s11481-015-9614-0

  193. 193.

    Li J, Chen S, Xiao X, Zhao Y, Ding W, Li XC. IL-9 and Th9 cells in health and diseases-from tolerance to immunopathology. Cytokine Growth Factor Rev. 2017;37:47-55.

    Not in our library10.1016/j.cytogfr.2017.07.004

  194. 194.

    Li R, Rezk A, Ghadiri M, Luessi F, Zipp F, Li H, Giacomini PS, Antel J, Bar-Or A. Dimethyl fumarate treatment mediates an anti-inflammatory shift in B cell subsets of patients with multiple sclerosis. J Immunol. 2017;198(2):691-698.

    Not in our library10.4049/jimmunol.1601649

  195. 195.

    Li R, Tropea TF, Baratta LR, Zuroff L, Diaz-Ortiz ME, Zhang B, Shinoda K, Rezk A, Alcalay RN, Chen-Plotkin A, Bar-Or A. Abnormal B-cell and Tfh-cell profiles in patients with parkinson disease: a cross-sectional study. Neurol Neuroimmunol Neuroinflamm. 2022;9(2):e1125.

    Not in our library10.1212/nxi.0000000000001125

  196. 196.

    Li W, Luo Y, Xu H, Ma Q, Yao Q. Imbalance between T helper 1 and regulatory T cells plays a detrimental role in experimental Parkinson’s disease in mice. J Int Med Res. 2021;49(4):300060521998471.

    Not in our library10.1177/0300060521998471

  197. 197.
  198. 198.

    Liu Q, Ju WK, Crowston JG, Xie F, Perry G, Smith MA, Lindsey JD, Weinreb RN. Oxidative stress is an early event in hydrostatic pressure induced retinal ganglion cell damage. Invest Ophthalmol Vis Sci. 2007;48(10):4580-4589.

    Not in our library10.1167/iovs.07-0170

  199. 199.

    Liu Y, You C, Zhang Z, Zhang J, Yan H. Roles of Treg/Th17 cell imbalance and neuronal damage in the visual dysfunction observed in experimental autoimmune optic neuritis chronologically. Neuromolecular Med. 2015;17(4):391-403.

    Not in our library10.1007/s12017-015-8368-4

  200. 200.

    Luger D, Silver PB, Tang J, Cua D, Chen Z, Iwakura Y, Bowman EP, Sgambellone NM, Chan CC, Caspi RR. Either a Th17 or a Th1 effector response can drive autoimmunity: conditions of disease induction affect dominant effector category. J Exp Med. 2008;205(4):799-810.

    Not in our library10.1084/jem.20071258

  201. 201.

    Luo C, Yang X, Kain AD, Powell DW, Kuehn MH, Tezel G. Glaucomatous tissue stress and the regulation of immune response through glial Toll-like receptor signaling. Invest Ophthalmol Vis Sci. 2010;51(11):5697-5707.

    Not in our library10.1167/iovs.10-5407

  202. 202.

    Machalinska A, Dziedziejko V, Mozolewska-Piotrowska K, Karczewicz D, Wiszniewska B, Machalinski B. Elevated plasma levels of C3a complement compound in the exudative form of age-related macular degeneration. Ophthalmic Res. 2009;42(1):54-59.

    Not in our library10.1159/000219686

  203. 203.

    Madelung CF, Falk MK, Sorensen TL. The association between neovascular age-related macular degeneration and regulatory T cells in peripheral blood. Clin Ophthalmol. 2015;9:1147-1154.

    Not in our library10.2147/opth.s82116

  204. 204.

    Maruyama I, Ohguro H, Ikeda Y. Retinal ganglion cells recognized by serum autoantibody against gamma-enolase found in glaucoma patients. Invest Ophthalmol Vis Sci. 2000;41(7):1657-1665.

    Not in our library

  205. 205.

    Mattapallil MJ, Sahin A, Silver PB, Sun SH, Chan CC, Remmers EF, Hejtmancik JF, Caspi RR. Common genetic determinants of uveitis shared with other autoimmune disorders. J Immunol. 2008;180(10):6751-6759.

    Not in our library10.4049/jimmunol.180.10.6751

  206. 206.

    McDonnell F, Irnaten M, Clark AF, O'Brien CJ, Wallace DM. Hypoxia-induced changes in DNA methylation alter RASAL1 and TGFbeta1 expression in human trabecular meshwork cells. PLoS ONE. 2016;11(4):e0153354.

    Not in our library10.1371/journal.pone.0153354

  207. 207.

    McGeer PL, Itagaki S, Boyes BE, McGeer EG. Reactive microglia are positive for HLA-DR in the substantia Nigra of Parkinson’s and Alzheimer’s disease brains. Neurology. 1988;38(8):1285-1291.

    Not in our library10.1212/wnl.38.8.1285

  208. 208.

    McKinnon SJ, Lehman DM, Tahzib NG, Ransom NL, Reitsamer HA, Liston P, LaCasse E, Li Q, Korneluk RG, Hauswirth WW. Baculoviral IAP repeat-containing-4 protects optic nerve axons in a rat glaucoma model. Mol Ther. 2002;5(6):780-787.

    Not in our library10.1006/mthe.2002.0608

  209. 209.

    McPherson RC, Cambrook HE, O'Connor RA, Anderton SM. Induction of passive EAE using myelin-reactive CD4+ T cells. Methods Mol Biol. 2014;1193:187-198.

    Not in our library10.1007/978-1-4939-1212-4_17

  210. 210.

    McPherson SW, Yang J, Chan CC, Dou C, Gregerson DS. Resting CD8 T cells recognize beta-galactosidase expressed in the immune-privileged retina and mediate autoimmune disease when activated. Immunology. 2003;110(3):386-396.

    Not in our library10.1046/j.1365-2567.2003.01750.x

  211. 211.

    Mexhitaj I, Nyirenda MH, Li R, O'Mahony J, Rezk A, Rozenberg A, Moore CS, Johnson T, Sadovnick D, Collins DL, Arnold DL, Gran B, Yeh EA, Marrie RA, Banwell B, Bar-Or A. Abnormal effector and regulatory T cell subsets in paediatric-onset multiple sclerosis. Brain. 2019;142(3):617-632.

    Not in our library10.1093/brain/awz017

  212. 212.

    Mietelska-Porowska A, Wojda U. T lymphocytes and inflammatory mediators in the interplay between brain and blood in Alzheimer’s disease: potential pools of new biomarkers. J Immunol Res. 2017;2017:4626540.

    Not in our library10.1155/2017/4626540

  213. 213.
  214. 214.

    Miserocchi E, Pontikaki I, Modorati G, Bandello F, Meroni PL, Gerloni V. Rituximab for uveitis. Ophthalmology. 2011;118(1):223-224.

    Not in our library10.1016/j.ophtha.2010.07.031

  215. 215.

    Mo C, Zeng Z, Deng Q, Ding Y, Xiao R. Imbalance between T helper 17 and regulatory T cell subsets plays a significant role in the pathogenesis of systemic sclerosis. Biomed Pharmacother. 2018;108:177-183.

    Not in our library10.1016/j.biopha.2018.09.037

  216. 216.

    Mo FM, Proia AD, Johnson WH, Cyr D, Lashkari K. Interferon gamma-inducible protein-10 (IP-10) and eotaxin as biomarkers in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2010;51(8):4226-4236.

    Not in our library10.1167/iovs.09-3910

  217. 217.

    Morohoshi K, Goodwin AM, Ohbayashi M, Ono SJ. Autoimmunity in retinal degeneration: autoimmune retinopathy and age-related macular degeneration. J Autoimmun. 2009;33(3–4):247-254.

    Not in our library10.1016/j.jaut.2009.09.003

  218. 218.

    Morohoshi K, Ohbayashi M, Patel N, Chong V, Bird AC, Ono SJ. Identification of anti-retinal antibodies in patients with age-related macular degeneration. Exp Mol Pathol. 2012;93(2):193-199.

    Not in our library10.1016/j.yexmp.2012.03.007

  219. 219.
  220. 220.

    Muhammad F, Wang D, Montieth A, Lee S, Preble J, Foster CS, Larson TA, Ding K, Dvorak JD, Lee DJ. PD-1(+) melanocortin receptor dependent-Treg cells prevent autoimmune disease. Sci Rep. 2019;9(1):16941.

    Not in our library10.1038/s41598-019-53297-w

  221. 221.

    Nadeem A, Javaid K, Sami W, Zafar A, Jahan S, Zaman S, Nagi A. Inverse relationship of serum IL-17 with type-II diabetes retinopathy. Clin Lab. 2013;59(11–12):1311-1317.

    Not in our library10.7754/clin.lab.2013.121140

  222. 222.

    Nanke Y, Kotake S, Goto M, Ujihara H, Matsubara M, Kamatani N. Decreased percentages of regulatory T cells in peripheral blood of patients with Behcet’s disease before ocular attack: a possible predictive marker of ocular attack. Mod Rheumatol. 2008;18(4):354-358.

    Not in our library10.3109/s10165-008-0064-x

  223. 223.

    Nassar K, Grisanti S, Elfar E, Luke J, Luke M, Grisanti S. Serum cytokines as biomarkers for age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 2015;253(5):699-704.

    Not in our library10.1007/s00417-014-2738-8

  224. 224.
  225. 225.

    Niazi S, Krogh Nielsen M, Sorensen TL, Subhi Y. Neutrophil-to-lymphocyte ratio in age-related macular degeneration: a systematic review and meta-analysis. Acta Ophthalmol. 2019;97(6):558-566.

    Not in our library10.1111/aos.14072

  226. 226.

    Nickells RW. Apoptosis of retinal ganglion cells in glaucoma: an update of the molecular pathways involved in cell death. Surv Ophthalmol. 1999;43(Suppl 1):S151-161.

    Not in our library10.1016/s0039-6257(99)00029-6

  227. 227.

    Niederkorn JY. Immune privilege in the anterior chamber of the eye. Crit Rev Immunol. 2002;22(1):13-46.

    Not in our library10.1615/critrevimmunol.v22.i1.20

  228. 228.
  229. 229.

    Niwa F, Kuriyama N, Nakagawa M, Imanishi J. Effects of peripheral lymphocyte subpopulations and the clinical correlation with Parkinson’s disease. Geriatr Gerontol Int. 2012;12(1):102-107.

    Not in our library10.1111/j.1447-0594.2011.00740.x

  230. 230.

    Oddo S, Caccamo A, Shepherd JD, Murphy MP, Golde TE, Kayed R, Metherate R, Mattson MP, Akbari Y, LaFerla FM. Triple-transgenic model of Alzheimer’s disease with plaques and tangles: intracellular Abeta and synaptic dysfunction. Neuron. 2003;39(3):409-421.

    Not in our library10.1016/s0896-6273(03)00434-3

  231. 231.

    Ohl K, Tenbrock K. Regulatory T cells in systemic lupus erythematosus. Eur J Immunol. 2015;45(2):344-355.

    Not in our library10.1002/eji.201344280

  232. 232.

    Oladipupo FO, Yu C-R, Olumuyide E, Jittaysothorn Y, Choi JK, Egwuagu CE. STAT3 deficiency in B cells exacerbates uveitis by promoting expansion of pathogenic lymphocytes and suppressing regulatory B cells (Bregs) and Tregs. Sci Rep. 2020;10(1):16188.

    Not in our library10.1038/s41598-020-73093-1

  233. 233.

    Opal SM, DePalo VA. Anti-inflammatory cytokines. Chest. 2000;117(4):1162-1172.

    Not in our library10.1378/chest.117.4.1162

  234. 234.

    Osborne NN, Casson RJ, Wood JP, Chidlow G, Graham M, Melena J. Retinal ischemia: mechanisms of damage and potential therapeutic strategies. Prog Retin Eye Res. 2004;23(1):91-147.

    Not in our library10.1016/j.preteyeres.2003.12.001

  235. 235.

    Papachroni KK, Ninkina N, Papapanagiotou A, Hadjigeorgiou GM, Xiromerisiou G, Papadimitriou A, Kalofoutis A, Buchman VL. Autoantibodies to alpha-synuclein in inherited Parkinson’s disease. J Neurochem. 2007;101(3):749-756.

    Not in our library10.1111/j.1471-4159.2006.04365.x

  236. 236.

    Park KH, Cozier F, Ong OC, Caprioli J. Induction of heat shock protein 72 protects retinal ganglion cells in a rat glaucoma model. Invest Ophthalmol Vis Sci. 2001;42(7):1522-1530.

    Not in our library

  237. 237.

    Park Y, Cho KJ. Choroidal vascular index in patients with open angle glaucoma and preperimetric glaucoma. PLoS ONE. 2019;14(3):e0213336.

    Not in our library10.1371/journal.pone.0213336

  238. 238.

    Patel HR, Hariprasad SM, Eichenbaum D. Geographic atrophy: clinical impact and emerging treatments. Ophthalmic Surg Lasers Imaging Retina. 2015;46(1):8-13.

    Not in our library10.3928/23258160-20150101-01

  239. 239.

    Patel M, Chan CC. Immunopathological aspects of age-related macular degeneration. Semin Immunopathol. 2008;30(2):97-110.

    Not in our library10.1007/s00281-008-0112-9

  240. 240.

    Pease ME, McKinnon SJ, Quigley HA, Kerrigan-Baumrind LA, Zack DJ. Obstructed axonal transport of BDNF and its receptor TrkB in experimental glaucoma. Invest Ophthalmol Vis Sci. 2000;41(3):764-774.

    Not in our library

  241. 241.

    Peeters LM, Vanheusden M, Somers V, Van Wijmeersch B, Stinissen P, Broux B, Hellings N. Cytotoxic CD4+ T cells drive multiple sclerosis progression. Front Immunol. 2017;8:1160.

    Not in our library10.3389/fimmu.2017.01160

  242. 242.
  243. 243.

    Penfold PL, Provis JM, Furby JH, Gatenby PA, Billson FA. Autoantibodies to retinal astrocytes associated with age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 1990;228(3):270-274.

    Not in our library10.1007/bf00920033

  244. 244.

    Pereira LMS, Gomes STM, Ishak R, Vallinoto ACR. Regulatory T cell and Forkhead box protein 3 as modulators of immune homeostasis. Front Immunol. 2017;8:605.

    Not in our library10.3389/fimmu.2017.00605

  245. 245.

    Pérez-Cerdá F, Sánchez-Gómez MV, Matute C. The link of inflammation and neurodegeneration in progressive multiple sclerosis. Mult Scler Demyelinating Disord. 2016;1(1):9.

    Not in our library10.1186/s40893-016-0012-0

  246. 246.

    Pletinckx K, Vaeth M, Schneider T, Beyersdorf N, Hunig T, Berberich-Siebelt F, Lutz MB. Immature dendritic cells convert anergic nonregulatory T cells into Foxp3- IL-10+ regulatory T cells by engaging CD28 and CTLA-4. Eur J Immunol. 2015;45(2):480-491.

    Not in our library10.1002/eji.201444991

  247. 247.

    Popescu BF, Pirko I, Lucchinetti CF. Pathology of multiple sclerosis: where do we stand? Continuum (Minneap Minn). 2013;19(4):901-921.

    Not in our library10.1212/01.con.0000433291.23091.65

  248. 248.

    Praksova P, Stourac P, Bednarik J, Vlckova E, Mikulkova Z, Michalek J. Immunoregulatory T cells in multiple sclerosis and the effect of interferon beta and glatiramer acetate treatment on T cell subpopulations. J Neurol Sci. 2012;319(1–2):18-23.

    Not in our library10.1016/j.jns.2012.05.036

  249. 249.

    Prosperini L, Annovazzi P, Boffa L, Buscarinu MC, Gallo A, Matta M, Moiola L, Musu L, Perini P, Avolio C, Barcella V, Bianco A, Farina D, Ferraro E, Pontecorvo S, Granella F, Grimaldi LME, Laroni A, Lus G, Patti F, Pucci E, Pasca M, Sarchielli P, G. Italian Alemtuzumab Study. No evidence of disease activity (NEDA-3) and disability improvement after alemtuzumab treatment for multiple sclerosis: a 36-month real-world study. J Neurol. 2018;265(12):2851-2860.

    Not in our library10.1007/s00415-018-9070-x

  250. 250.

    Qian L, Flood PM, Hong JS. Neuroinflammation is a key player in Parkinson’s disease and a prime target for therapy. J Neural Transm (Vienna). 2010;117(8):971-979.

    Not in our library10.1007/s00702-010-0428-1

  251. 251.

    Qiao YC, Shen J, He L, Hong XZ, Tian F, Pan YH, Liang L, Zhang XX, Zhao HL. Changes of regulatory T cells and of proinflammatory and immunosuppressive cytokines in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. J Diabetes Res. 2016;2016:3694957.

    Not in our library10.1155/2016/3694957

  252. 252.

    Qing G, Duan X, Jiang Y. Heat shock protein 72 protects retinal ganglion cells in rat model of acute glaucoma. Yan Ke Xue Bao. 2005;21(3):163-168.

    Not in our library

  253. 253.

    Qiu AW, Bian Z, Mao PA, Liu QH. IL-17A exacerbates diabetic retinopathy by impairing Muller cell function via Act1 signaling. Exp Mol Med. 2016;48(12):e280.

    Not in our library10.1038/emm.2016.117

  254. 254.

    Qiu AW, Liu QH, Wang JL. Blocking IL-17A alleviates diabetic retinopathy in rodents. Cell Physiol Biochem. 2017;41(3):960-972.

    Not in our library10.1159/000460514

  255. 255.

    Quigley HA. Neuronal death in glaucoma. Prog Retin Eye Res. 1999;18(1):39-57.

    Not in our library10.1016/s1350-9462(98)00014-7

  256. 256.

    Quigley HA, McKinnon SJ, Zack DJ, Pease ME, Kerrigan-Baumrind LA, Kerrigan DF, Mitchell RS. Retrograde axonal transport of BDNF in retinal ganglion cells is blocked by acute IOP elevation in rats. Invest Ophthalmol Vis Sci. 2000;41(11):3460-3466.

    Not in our library

  257. 257.

    Reale M, Iarlori C, Thomas A, Gambi D, Perfetti B, Di Nicola M, Onofrj M. Peripheral cytokines profile in Parkinson’s disease. Brain Behav Immun. 2009;23(1):55-63.

    Not in our library10.1016/j.bbi.2008.07.003

  258. 258.

    Reddy J, Illes Z, Zhang X, Encinas J, Pyrdol J, Nicholson L, Sobel RA, Wucherpfennig KW, Kuchroo VK. Myelin proteolipid protein-specific CD4+CD25+ regulatory cells mediate genetic resistance to experimental autoimmune encephalomyelitis. Proc Natl Acad Sci U S A. 2004;101(43):15434-15439.

    Not in our library10.1073/pnas.0404444101

  259. 259.

    Rentzos M, Nikolaou C, Andreadou E, Paraskevas GP, Rombos A, Zoga M, Tsoutsou A, Boufidou F, Kapaki E, Vassilopoulos D. Circulating interleukin-15 and RANTES chemokine in Parkinson’s disease. Acta Neurol Scand. 2007;116(6):374-379.

    Not in our library10.1111/j.1600-0404.2007.00894.x

  260. 260.

    Reynolds AD, Banerjee R, Liu J, Gendelman HE, Mosley RL. Neuroprotective activities of CD4+CD25+ regulatory T cells in an animal model of Parkinson’s disease. J Leukoc Biol. 2007;82(5):1083-1094.

    Not in our library10.1189/jlb.0507296

  261. 261.

    Reynolds AD, Stone DK, Hutter JA, Benner EJ, Mosley RL, Gendelman HE. Regulatory T cells attenuate Th17 cell-mediated nigrostriatal dopaminergic neurodegeneration in a model of Parkinson’s disease. J Immunol. 2010;184(5):2261-2271.

    Not in our library10.4049/jimmunol.0901852

  262. 262.

    Richartz-Salzburger E, Batra A, Stransky E, Laske C, Kohler N, Bartels M, Buchkremer G, Schott K. Altered lymphocyte distribution in Alzheimer’s disease. J Psychiatr Res. 2007;41(1–2):174-178.

    Not in our library10.1016/j.jpsychires.2006.01.010

  263. 263.

    Rohrer B, Frazer-Abel A, Leonard A, Ratnapriya R, Ward T, Pietraszkiewicz A, O'Quinn E, Adams K, Swaroop A, Wolf BJ. Association of age-related macular degeneration with complement activation products, smoking, and single nucleotide polymorphisms in South Carolinians of European and African descent. Mol Vis. 2019;25:79-92.

    Not in our library

  264. 264.

    Romano C, Barrett DA, Li Z, Pestronk A, Wax MB. Anti-rhodopsin antibodies in sera from patients with normal-pressure glaucoma. Invest Ophthalmol Vis Sci. 1995;36(10):1968-1975.

    Not in our library

  265. 265.

    Rose NR. Prediction and prevention of autoimmune disease in the 21st century: a review and preview. Am J Epidemiol. 2016;183(5):403-406.

    Not in our library10.1093/aje/kwv292

  266. 266.

    Rosenblum MD, Remedios KA, Abbas AK. Mechanisms of human autoimmunity. J Clin Invest. 2015;125(6):2228-2233.

    Not in our library10.1172/jci78088

  267. 267.

    Rosenblum MD, Way SS, Abbas AK. Regulatory T cell memory. Nat Rev Immunol. 2016;16(2):90-101.

    Not in our library10.1038/nri.2015.1

  268. 268.

    Rosso M, Chitnis T. Association between cigarette smoking and multiple sclerosis: a review. JAMA Neurol. 2019.

    Not in our library10.1001/jamaneurol.2019.4271

  269. 269.

    Ruggieri S, Frassanito MA, Dammacco R, Guerriero S. Treg lymphocytes in autoimmune uveitis. Ocul Immunol Inflamm. 2012;20(4):255-261.

    Not in our library10.3109/09273948.2012.681830

  270. 270.

    Sabatino JJ, Probstel AK, Zamvil SS. B cells in autoimmune and neurodegenerative central nervous system diseases. Nat Rev Neurosci. 2019;20(12):728-745.

    Not in our library10.1038/s41583-019-0233-2

  271. 271.

    Sabatino JJ, Zamvil SS, Hauser SL. B-cell therapies in multiple sclerosis. Cold Spring Harb Perspect Med. 2019;9(2):a032037.

    Not in our library10.1101/cshperspect.a032037

  272. 272.

    Sacca SC, Izzotti A, Rossi P, Traverso C. Glaucomatous outflow pathway and oxidative stress. Exp Eye Res. 2007;84(3):389-399.

    Not in our library10.1016/j.exer.2006.10.008

  273. 273.

    Salani F, Sterbini V, Sacchinelli E, Garramone M, Bossu P. Is innate memory a double-edge sword in Alzheimer’s disease? A reappraisal of new concepts and old data. Front Immunol. 2019;10:1768.

    Not in our library10.3389/fimmu.2019.01768

  274. 274.
  275. 275.

    Schafflick D, Wolbert J, Heming M, Thomas C, Hartlehnert M, Borsch AL, Ricci A, Martin-Salamanca S, Li X, Lu IN, Pawlak M, Minnerup J, Strecker JK, Seidenbecher T, Meuth SG, Hidalgo A, Liesz A, Wiendl H, Meyer Zu Horste G. Single-cell profiling of CNS border compartment leukocytes reveals that B cells and their progenitors reside in non-diseased meninges. Nat Neurosci. 2021;24:1225.

    Not in our library10.1038/s41593-021-00880-y

  276. 276.

    Schmitt HM, Pelzel HR, Schlamp CL, Nickells RW. Histone deacetylase 3 (HDAC3) plays an important role in retinal ganglion cell death after acute optic nerve injury. Mol Neurodegener. 2014;9:39.

    Not in our library10.1186/1750-1326-9-39

  277. 277.

    Schneider L. A resurrection of aducanumab for Alzheimer’s disease. Lancet Neurol. 2020;19(2):111-112.

    Not in our library10.1016/s1474-4422(19)30480-6

  278. 278.

    Schwartz M, Baruch K. Breaking peripheral immune tolerance to CNS antigens in neurodegenerative diseases: boosting autoimmunity to fight-off chronic neuroinflammation. J Autoimmun. 2014;54:8-14.

    Not in our library10.1016/j.jaut.2014.08.002

  279. 279.

    Sebina I, Pepper M. Humoral immune responses to infection: common mechanisms and unique strategies to combat pathogen immune evasion tactics. Curr Opin Immunol. 2018;51:46-54.

    Not in our library10.1016/j.coi.2018.02.001

  280. 280.

    Serpente M, Bonsi R, Scarpini E, Galimberti D. Innate immune system and inflammation in Alzheimer’s disease: from pathogenesis to treatment. NeuroImmunoModulation. 2014;21(2–3):79-87.

    Not in our library10.1159/000356529

  281. 281.

    Severin ME, Lee PW, Liu Y, Selhorst AJ, Gormley MG, Pei W, Yang Y, Guerau-de-Arellano M, Racke MK, Lovett-Racke AE. MicroRNAs targeting TGFbeta signalling underlie the regulatory T cell defect in multiple sclerosis. Brain. 2016;139(Pt 6):1747-1761.

    Not in our library10.1093/brain/aww084

  282. 282.

    Sevigny J, Chiao P, Bussiere T, Weinreb PH, Williams L, Maier M, Dunstan R, Salloway S, Chen T, Ling Y, O'Gorman J, Qian F, Arastu M, Li M, Chollate S, Brennan MS, Quintero-Monzon O, Scannevin RH, Arnold HM, Engber T, Rhodes K, Ferrero J, Hang Y, Mikulskis A, Grimm J, Hock C, Nitsch RM, Sandrock A. The antibody aducanumab reduces Abeta plaques in Alzheimer’s disease. Nature. 2016;537(7618):50-56.

    Not in our library10.1038/nature19323

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    Shao H, Sun SL, Kaplan HJ, Sun D. Characterization of rat CD8+ uveitogenic T cells specific for interphotoreceptor retinal-binding protein 1177–1191. J Immunol. 2004;173(4):2849-2854.

    Not in our library10.4049/jimmunol.173.4.2849

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    Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Amital H, Shoenfeld Y. Physical activity and autoimmune diseases: get moving and manage the disease. Autoimmun Rev. 2018;17(1):53-72.

    Not in our library10.1016/j.autrev.2017.11.010

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    Sheikh V, Zamani A, Mahabadi-Ashtiyani E, Tarokhian H, Borzouei S, Alahgholi-Hajibehzad M. Decreased regulatory function of CD4(+)CD25(+)CD45RA(+) T cells and impaired IL-2 signalling pathway in patients with type 2 diabetes mellitus. Scand J Immunol. 2018;88(4):e12711.

    Not in our library10.1111/sji.12711

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    Sheu A, Chan Y, Ferguson A, Bakhtyari MB, Hawke W, White C, Chan YF, Bertolino PJ, Woon HG, Palendira U, Sierro F, Lau SM. A proinflammatory CD4(+) T cell phenotype in gestational diabetes mellitus. Diabetologia. 2018;61(7):1633-1643.

    Not in our library10.1007/s00125-018-4615-1

  287. 287.

    Shi YH, Shi GC, Wan HY, Ai XY, Zhu HX, Tang W, Ma JY, Jin XY, Zhang BY. An increased ratio of Th2/Treg cells in patients with moderate to severe asthma. Chin Med J (Engl). 2013;126(12):2248-2253.

    Not in our library

  288. 288.

    Shin JI, Bayry J. A role for IL-17 in age-related macular degeneration. Nat Rev Immunol. 2013;13(9):701.

    Not in our library10.1038/nri3459-c1

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    Shishido SN, Varahan S, Yuan K, Li X, Fleming SD. Humoral innate immune response and disease. Clin Immunol. 2012;144(2):142-158.

    Not in our library10.1016/j.clim.2012.06.002

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    Siepmann K, Biester S, Plskova J, Muckersie E, Duncan L, Forrester JV. CD4+CD25+ T regulatory cells induced by LPS-activated bone marrow dendritic cells suppress experimental autoimmune uveoretinitis in vivo. Graefes Arch Clin Exp Ophthalmol. 2007;245(2):221-229.

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    Sigurdardottir S, Zapadka TE, Lindstrom SI, Liu H, Taylor BE, Lee CA, Kern TS, Taylor PR. Diabetes-mediated IL-17A enhances retinal inflammation, oxidative stress, and vascular permeability. Cell Immunol. 2019;341:103921.

    Not in our library10.1016/j.cellimm.2019.04.009

  292. 292.

    Silva Morales M, Mueller D. Anergy into T regulatory cells: an integration of metabolic cues and epigenetic changes at the Foxp3 conserved non-coding sequence 2. F1000Res 2018;7.

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  293. 293.

    Silver PB, Horai R, Chen J, Jittayasothorn Y, Chan CC, Villasmil R, Kesen MR, Caspi RR. Retina-specific T regulatory cells bring about resolution and maintain remission of autoimmune uveitis. J Immunol. 2015;194(7):3011-3019.

    Not in our library10.4049/jimmunol.1402650

  294. 294.

    Singh A, Subhi Y, Krogh Nielsen M, Falk MK, Matzen SMH, Sellebjerg F, Sorensen TL. Systemic frequencies of T helper 1 and T helper 17 cells in patients with age-related macular degeneration: a case-control study. Sci Rep. 2017;7(1):605.

    Not in our library10.1038/s41598-017-00741-4

  295. 295.

    Singh RP, Elman MJ, Singh SK, Fung AE, Stoilov I. Advances in the treatment of diabetic retinopathy. J Diabetes Complications. 2019;33(12):107417.

    Not in our library10.1016/j.jdiacomp.2019.107417

  296. 296.

    Smith JR, Stempel AJ, Bharadwaj A, Appukuttan B. Involvement of B cells in non-infectious uveitis. Clin Transl Immunol. 2016;5(2):e63-e63.

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    Sojka DK, Huang YH, Fowell DJ. Mechanisms of regulatory T-cell suppression—a diverse arsenal for a moving target. Immunology. 2008;124(1):13-22.

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  298. 298.

    Sollvander S, Ekholm-Pettersson F, Brundin RM, Westman G, Kilander L, Paulie S, Lannfelt L, Sehlin D. Increased number of plasma B cells producing autoantibodies against Abeta42 protofibrils in Alzheimer’s disease. J Alzheimers Dis. 2015;48(1):63-72.

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    Sommer A, Tielsch JM, Katz J, Quigley HA, Gottsch JD, Javitt J, Singh K. Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans. The Baltimore Eye Survey. Arch Ophthalmol. 1991;109(8):1090-1095.

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    Song L, Le J, Ye F, Shao H, Kaplan HJ, Sun D. Sequence 168 to 177 of interphotoreceptor retinoid-binding protein (IRBP) is an antigenic epitope for autoreactive CD8 T cells in the B10RIII mouse. J Neuroimmunol. 2008;193(1–2):68-76.

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  301. 301.

    Stevens CH, Rowe D, Morel-Kopp MC, Orr C, Russell T, Ranola M, Ward C, Halliday GM. Reduced T helper and B lymphocytes in Parkinson’s disease. J Neuroimmunol. 2012;252(1–2):95-99.

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    Stojanovich L, Marisavljevich D. Stress as a trigger of autoimmune disease. Autoimmun Rev. 2008;7(3):209-213.

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    Streilein JW, Stein-Streilein J. Does innate immune privilege exist? J Leukoc Biol. 2000;67(4):479-487.

    Not in our library10.1002/jlb.67.4.479

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    Stypula G, Kunert-Radek J, Stepien H, Zylinska K, Pawlikowski M. Evaluation of interleukins, ACTH, cortisol and prolactin concentrations in the blood of patients with Parkinson’s disease. NeuroImmunoModulation. 1996;3(2–3):131-134.

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    Subhi Y, Lykke Sorensen T. New neovascular age-related macular degeneration is associated with systemic leucocyte activity. Acta Ophthalmol. 2017;95(5):472-480.

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    Sulzer D, Alcalay RN, Garretti F, Cote L, Kanter E, Agin-Liebes J, Liong C, McMurtrey C, Hildebrand WH, Mao X, Dawson VL, Dawson TM, Oseroff C, Pham J, Sidney J, Dillon MB, Carpenter C, Weiskopf D, Phillips E, Mallal S, Peters B, Frazier A, Lindestam Arlehamn CS, Sette A. T cells from patients with Parkinson’s disease recognize alpha-synuclein peptides. Nature. 2017;546(7660):656-661.

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    Takeda A, Sonoda K-H, Ishibashi T. Regulation of Th1 and Th17 cell differentiation in uveitis. Inflamm Regen. 2013;33(5):261-268.

    Not in our library10.2492/inflammregen.33.261

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    Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102(6):653-657.

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  310. 310.

    Taylor AW, Yee DG, Streilein JW. Suppression of nitric oxide generated by inflammatory macrophages by calcitonin gene-related peptide in aqueous humor. Invest Ophthalmol Vis Sci. 1998;39(8):1372-1378.

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    Tesmer LA, Lundy SK, Sarkar S, Fox DA. Th17 cells in human disease. Immunol Rev. 2008;223:87-113.

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    Tezel G. TNF-alpha signaling in glaucomatous neurodegeneration. Prog Brain Res. 2008;173:409-421.

    Not in our library10.1016/s0079-6123(08)01128-x

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    Tezel G, Edward DP, Wax MB. Serum autoantibodies to optic nerve head glycosaminoglycans in patients with glaucoma. Arch Ophthalmol. 1999;117(7):917-924.

    Not in our library10.1001/archopht.117.7.917

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    Tezel G, Fourth APORICWG. The role of glia, mitochondria, and the immune system in glaucoma. Invest Ophthalmol Vis Sci. 2009;50(3):1001-1012.

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  315. 315.

    Tezel G, Hernandez R, Wax MB. Immunostaining of heat shock proteins in the retina and optic nerve head of normal and glaucomatous eyes. Arch Ophthalmol. 2000;118(4):511-518.

    Not in our library10.1001/archopht.118.4.511

  316. 316.

    Tezel G, Li LY, Patil RV, Wax MB. TNF-alpha and TNF-alpha receptor-1 in the retina of normal and glaucomatous eyes. Invest Ophthalmol Vis Sci. 2001;42(8):1787-1794.

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  317. 317.

    Tezel G, Seigel GM, Wax MB. Autoantibodies to small heat shock proteins in glaucoma. Invest Ophthalmol Vis Sci. 1998;39(12):2277-2287.

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  318. 318.

    Tezel G, Yang J, Wax MB. Heat shock proteins, immunity and glaucoma. Brain Res Bull. 2004;62(6):473-480.

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    Tezel G, Yang X, Luo C, Peng Y, Sun SL, Sun D. Mechanisms of immune system activation in glaucoma: oxidative stress-stimulated antigen presentation by the retina and optic nerve head glia. Invest Ophthalmol Vis Sci. 2007;48(2):705-714.

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    Thomas CN, Berry M, Logan A, Blanch RJ, Ahmed Z. Caspases in retinal ganglion cell death and axon regeneration. Cell Death Discov. 2017;3:17032.

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    Togo T, Akiyama H, Iseki E, Kondo H, Ikeda K, Kato M, Oda T, Tsuchiya K, Kosaka K. Occurrence of T cells in the brain of Alzheimer’s disease and other neurological diseases. J Neuroimmunol. 2002;124(1–2):83-92.

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  322. 322.

    Toomey CB, Johnson LV, Bowes Rickman C. Complement factor H in AMD: bridging genetic associations and pathobiology. Prog Retin Eye Res. 2018;62:38-57.

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    Vendomele J, Khebizi Q, Fisson S. Cellular and molecular mechanisms of anterior chamber-associated immune deviation (ACAID): what we have learned from knockout mice. Front Immunol. 2017;8:1686.

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  325. 325.

    Vidal-Sanz M, Salinas-Navarro M, Nadal-Nicolas FM, Alarcon-Martinez L, Valiente-Soriano FJ, de Imperial JM, Aviles-Trigueros M, Agudo-Barriuso M, Villegas-Perez MP. Understanding glaucomatous damage: anatomical and functional data from ocular hypertensive rodent retinas. Prog Retin Eye Res. 2012;31(1):1-27.

    Not in our library10.1016/j.preteyeres.2011.08.001

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    Viglietta V, Baecher-Allan C, Weiner HL, Hafler DA. Loss of functional suppression by CD4+CD25+ regulatory T cells in patients with multiple sclerosis. J Exp Med. 2004;199(7):971-979.

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    Vrabec JP, Levin LA. The neurobiology of cell death in glaucoma. Eye (Lond). 2007;21(Suppl 1):S11-14.

    Not in our library10.1038/sj.eye.6702880

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    Vyas SP, Goswami R. A decade of Th9 cells: role of Th9 cells in inflammatory bowel disease. Front Immunol. 2018;9:1139.

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    Wajih Ullah M, Qaseem A, Amray A. Post vaccination Guillain Barre syndrome: a case report. Cureus. 2018;10(4):e2511.

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    Wang GH, Xing YQ. Evaluation of heat shock protein (HSP-72) expression in retinal ganglion cells of rats with glaucoma. Exp Ther Med. 2017;14(2):1577-1581.

    Not in our library10.3892/etm.2017.4635

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    Wang L, Wang FS, Gershwin ME. Human autoimmune diseases: a comprehensive update. J Intern Med. 2015;278(4):369-395.

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    Wang P, Luo M, Zhou W, Jin X, Xu Z, Yan S, Li Y, Xu C, Cheng R, Huang Y, Lin X, Yao L, Nie H, Jiang Q. Global characterization of peripheral B cells in Parkinson’s disease by single-cell RNA and BCR sequencing. Front Immunol. 2022;13:814239.

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    Wang S, Wang X, Cheng Y, Ouyang W, Sang X, Liu J, Su Y, Liu Y, Li C, Yang L, Jin L, Wang Z. Autophagy dysfunction, cellular senescence, and abnormal immune-inflammatory responses in AMD: from mechanisms to therapeutic potential. Oxid Med Cell Longev. 2019;2019:3632169.

    Not in our library10.1155/2019/3632169

  335. 335.

    Wax MB. The case for autoimmunity in glaucoma. Exp Eye Res. 2011;93(2):187-190.

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    Wax MB, Tezel G, Yang J, Peng G, Patil RV, Agarwal N, Sappington RM, Calkins DJ. Induced autoimmunity to heat shock proteins elicits glaucomatous loss of retinal ganglion cell neurons via activated T-cell-derived fas-ligand. J Neurosci. 2008;28(46):12085-12096.

    Not in our library10.1523/jneurosci.3200-08.2008

  337. 337.

    Weinstein JE, Pepple KL. Cytokines in uveitis. Curr Opin Ophthalmol. 2018;29(3):267-274.

    Not in our library10.1097/icu.0000000000000466

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    Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest. 2005;115(5):1111-1119.

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    Wheeler CJ, Seksenyan A, Koronyo Y, Rentsendorj A, Sarayba D, Wu H, Gragg A, Siegel E, Thomas D, Espinosa A, Thompson K, Black K, Koronyo-Hamaoui M, Pechnick R, Irvin DK. T-lymphocyte deficiency exacerbates behavioral deficits in the 6-OHDA unilateral lesion rat model for Parkinson’s disease. J Neurol Neurophysiol 2014;5(3).

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    Williams PA, Harder JM, Foxworth NE, Cochran KE, Philip VM, Porciatti V, Smithies O, John SW. Vitamin B3 modulates mitochondrial vulnerability and prevents glaucoma in aged mice. Science. 2017;355(6326):756-760.

    Not in our library10.1126/science.aal0092

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    Wing K, Sakaguchi S. Regulatory T cells exert checks and balances on self tolerance and autoimmunity. Nat Immunol. 2010;11(1):7-13.

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    Wong M, Huang P, Li W, Li Y, Zhang SS, Zhang C. T-helper1/T-helper2 cytokine imbalance in the iris of patients with glaucoma. PLoS ONE. 2015;10(3):e0122184.

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    Wong WL, Su X, Li X, Cheung CM, Klein R, Cheng CY, Wong TY. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(2):e106-116.

    Not in our library10.1016/s2214-109x(13)70145-1

  345. 345.

    Wu Q, Liu B, Yuan L, Peng Q, Cheng L, Zhong P, Yang X, Yu H. Dysregulations of follicular helper T cells through IL-21 pathway in age-related macular degeneration. Mol Immunol. 2019;114:243-250.

    Not in our library10.1016/j.molimm.2019.07.028

  346. 346.

    Wu WK, Georgiadis A, Copland DA, Liyanage S, Luhmann UF, Robbie SJ, Liu J, Wu J, Bainbridge JW, Bates DO, Ali RR, Nicholson LB, Dick AD. IL-4 regulates specific Arg-1(+) macrophage sFlt-1-mediated inhibition of angiogenesis. Am J Pathol. 2015;185(8):2324-2335.

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  348. 348.

    Yang J, Tezel G, Patil RV, Romano C, Wax MB. Serum autoantibody against glutathione S-transferase in patients with glaucoma. Invest Ophthalmol Vis Sci. 2001;42(6):1273-1276.

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    Yang L, Guo C, Zhu J, Feng Y, Chen W, Feng Z, Wang D, Sun S, Lin W, Wang Y. Increased levels of pro-inflammatory and anti-inflammatory cellular responses in Parkinson’s disease patients: search for a disease indicator. Med Sci Monit. 2017;23:2972-2978.

    Not in our library10.12659/msm.904240

  350. 350.

    Yang M, Shi XQ, Peyret C, Oladiran O, Wu S, Chambon J, Fournier S, Zhang J. Effector/memory CD8(+) T cells synergize with co-stimulation competent macrophages to trigger autoimmune peripheral neuropathy. Brain Behav Immun. 2018;71:142-157.

    Not in our library10.1016/j.bbi.2018.04.001

  351. 351.

    Yang TT, Song SJ, Xue HB, Shi DF, Liu CM, Liu H. Regulatory T cells in the pathogenesis of type 2 diabetes mellitus retinopathy by miR-155. Eur Rev Med Pharmacol Sci. 2015;19(11):2010-2015.

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    Yang X, Luo C, Cai J, Powell DW, Yu D, Kuehn MH, Tezel G. Neurodegenerative and inflammatory pathway components linked to TNF-alpha/TNFR1 signaling in the glaucomatous human retina. Invest Ophthalmol Vis Sci. 2011;52(11):8442-8454.

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    Yang Z, Quigley HA, Pease ME, Yang Y, Qian J, Valenta D, Zack DJ. Changes in gene expression in experimental glaucoma and optic nerve transection: the equilibrium between protective and detrimental mechanisms. Invest Ophthalmol Vis Sci. 2007;48(12):5539-5548.

    Not in our library10.1167/iovs.07-0542

  354. 354.

    Yeh S, Li Z, Forooghian F, Hwang FS, Cunningham MA, Pantanelli S, Lew JC, Wroblewski KK, Vitale S, Nussenblatt RB. CD4+Foxp3+ T-regulatory cells in noninfectious uveitis. Arch Ophthalmol. 2009;127(4):407-413.

    Not in our library10.1001/archophthalmol.2009.32

  355. 355.

    Yokoyama Y, Aizawa N, Chiba N, Omodaka K, Nakamura M, Otomo T, Yokokura S, Fuse N, Nakazawa T. Significant correlations between optic nerve head microcirculation and visual field defects and nerve fiber layer loss in glaucoma patients with myopic glaucomatous disk. Clin Ophthalmol. 2011;5:1721-1727.

    Not in our library10.2147/opth.s23204

  356. 356.

    Yu HG, Lee DS, Seo JM, Ahn JK, Yu YS, Lee WJ, Chung H. The number of CD8+ T cells and NKT cells increases in the aqueous humor of patients with Behcet’s uveitis. Clin Exp Immunol. 2004;137(2):437-443.

    Not in our library10.1111/j.1365-2249.2004.02536.x

  357. 357.

    Yuan L, Neufeld AH. Tumor necrosis factor-alpha: a potentially neurodestructive cytokine produced by glia in the human glaucomatous optic nerve head. Glia. 2000;32(1):42-50.

    Not in our library10.1002/1098-1136(200010)32:1<42::aid-glia40>3.0.co;2-3

  358. 358.

    Yuan N, Zhang HF, Wei Q, Wang P, Guo WY. Expression of CD4+CD25+Foxp3+ regulatory T cells, interleukin 10 and transforming growth factor beta in newly diagnosed type 2 diabetic patients. Exp Clin Endocrinol Diabetes. 2018;126(2):96-101.

    Not in our library10.1055/s-0043-113454

  359. 359.

    Zaidi SAH, Guzman W, Singh S, Mehrotra S, Husain S. Changes in class I and IIb HDACs by delta-opioid in chronic rat glaucoma model. Invest Ophthalmol Vis Sci. 2020;61(14):4.

    Not in our library10.1167/iovs.61.14.4

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    Zaidi SAH, Thakore N, Singh S, Guzman W, Mehrotra S, Gangaraju V, Husain S. Histone deacetylases regulation by delta-opioids in human optic nerve head astrocytes. Invest Ophthalmol Vis Sci. 2020;61(11):17.

    Not in our library10.1167/iovs.61.11.17

  361. 361.

    Zhang JM, An J. Cytokines, inflammation, and pain. Int Anesthesiol Clin. 2007;45(2):27-37.

    Not in our library10.1097/aia.0b013e318034194e

  362. 362.

    Zhang N, Bevan MJ. CD8(+) T cells: foot soldiers of the immune system. Immunity. 2011;35(2):161-168.

    Not in our library10.1016/j.immuni.2011.07.010

  363. 363.

    Zhang Q, Fang W, Ma L, Wang ZD, Yang YM, Lu YQ. VEGF levels in plasma in relation to metabolic control, inflammation, and microvascular complications in type-2 diabetes: a cohort study. Medicine (Baltimore). 2018;97(15):e0415.

    Not in our library10.1097/md.0000000000010415

  364. 364.

    Zhao W, Yin Z, Li J, Ma M, Li C. Autoantibodies associated with glaucoma. Biomed Res-Tokyo. 2017;28:4913-4921.

    Not in our library

  365. 365.

    Zhao Z, Xu P, Jie Z, Zuo Y, Yu B, Soong L, Sun J, Chen Y, Cai J. gammadelta T cells as a major source of IL-17 production during age-dependent RPE degeneration. Invest Ophthalmol Vis Sci. 2014;55(10):6580-6589.

    Not in our library10.1167/iovs.14-15166

  366. 366.

    Zhou J, Wang S, Xia X. Role of intravitreal inflammatory cytokines and angiogenic factors in proliferative diabetic retinopathy. Curr Eye Res. 2012;37(5):416-420.

    Not in our library10.3109/02713683.2012.661114

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