Current insights in the pathogenesis of scleritis. (August 2020)

• Record Type: Journal Article
• Authors: Vergouwen, D.P.C.; Rothova, A.; Berge, J.C. Ten; Verdijk, R.M.; van Laar, J.A.M.; Vingerling, J.R.; Schreurs, M.W.J.
• Is Part Of: Experimental eye research. Volume 197(2020)
• Publication Date: 2020-08
• Subjects: Scleritis -- Pathology -- Immunology -- Autoimmunity -- Matrix metalloproteinases -- Imaging; Ophthalmology -- Periodicals; Eye -- Periodicals; Œil -- Périodiques; Ophthalmology; Periodicals; Electronic journals; 612.8405
• DOI: 10.1016/j.exer.2020.108078
• Languages: English
• ISSNs: 0014-4835

Abstract

Abstract: Scleritis is a sight-threatening inflammation characterized by severe pain and redness of the eye. It can cause blindness by severe complications like scleral and corneal necrosis, keratitis, and uveitis. The pathogenesis of scleritis is largely unknown due to a combination of the rarity of the disease, the little available human tissue-based research material, and the lack of animal models. The immune system is assumed to play a crucial role in the pathogenesis of scleritis. Multiple clues indicate probable antigenic stimuli in scleritis, and the involvement of matrix metalloproteinases in the destruction of scleral tissue. In this article we review the current insights into the pathogenesis of scleritis, and we suggest new hypotheses by implementing knowledge of systemic autoimmune disease pathogenesis. Understanding the pathogenesis of scleritis is crucial to improve the clinical management, as well as to find novel treatment modalities. Highlights: The pathogenesis of scleritis, a sight-threatening ocular inflammation characterized by intense pain, is largely unknown. Autoimmunity has been hypothesized, however, defining autoantibodies and/or T-cell reactivity are not yet clarified. Matrix metalloproteinases may be responsible for scleral destruction, their blockage may enrich current treatment options. Rapidly evolving imaging techniques can provide additional insight in the pathogenesis of scleritis.