Based on previous research on non-infectious uveitis, we made progress in the following areas: 1) Understanding the molecular mechanisms of Daclizumab in treating autoimmune originated uveitis. Daclizumab is known to block the alpha-chain (CD25) of the IL-2 receptor which is required for T cells to sense signals from T cell growth factor, IL-2. One of the arguments that was thought that might be against the application of Daclizumab was that IL-2 signaling was critical for activation induced cell death (AICD). Blockage of AICD could result in decreased apoptosis and increased lymphoproliferation. But clinical data proved that Daclizumab indeed ameliorated autoimmune uveitis and was an excellent alternative therapy. One of the hypotheses would be that in vivo blockage of CD25 in humans differ from inactivation of CD25 gene in mice. Multiple mechanisms could be contributing to Daclizumab effects besides its role in blocking IL-2 receptor. We continuousely monitored a group of patients who underwent Daclizumab therapy. We found that a sub-group of NK cells, called CD56bright, were induced in vivo after Daclizumab infusion. We showed that these cells secreted large amount of IL-10 and could be regulatory NK cells. We proposed that these induced CD56bright NK cells under Daclizumab therapy may be beneficial to the clinical outcome of uveitis patients. These findings have been published in the J. Immunology. 2)The role of GITRL in ocular tissues. We found that GITR expression correlated well with the clinical status of uveitis, hence, a marker for the disease status. We have published data to show that GITR can be used as a surrogate marker for the clinical activity of non-infectious uveitis. In addition, we have also focused on the role of GITR lignad (GITRL) in uveitis as well as the interaction of GITRL-GITR at the molecular level. We recently established a protocol that we can stain for GITRL expression on archived uvieits paraffin-embedded slides. We pursued studies on GITRL expression in humans under different pathological ocular conditions, e.g., uveitis and other inflammatory diseases. Our unpublsihed data suggest a differential expression pattern of GITRL in RPE cell and retina photoreceptors during ocular inflammatory responses (manuscript in preparation). 3) Further understanding of the triggering events for non-infectious uveitis. Despite intensive studies on animal models and using in vitro culturing system, the molecular mechanisms of non-infectious uveitis in humans are still an open question. we continue our interest in the search for antigens associated with uveitic conditions. Tropomyocin has been recently reported to cause uveitis in rats. We tested the uveitogenic tropomycin peptides. The recall responses (proliferation, cytokine profiles) of immune cells from Behcet's disease patients and from normal donors to tropomycin peptides, as well as to established human retinal S-antigen showed that more than 25% of uvietis patients showed T cell response to tropomyocin. We have also demonstrated anti-tropomyocin antibodies in the serum of uvieits patients. We have proposed that tropomyocin is one self-antigen for a sub-population of Bechets' patients. These findings have been published in Clin. Exp. Immunology. 4) Intensive efforts have also been made to understand the implication of GITRL expression in autoimmune uveitis patients as well as in other autoimmune diseases by studying the effects of the interaction between GITR and GITR ligand in vitro. We showed that the GITRL expression on retinal cells are induced by inflammatory cytokines. Overexpression of GITRL reversed physiological immune privilege of ocular RPE cells. We proposed that the expression of GITRL in ocular tissues is a natural way of balance between ocular immune privilege and inflammation responses (manuscript in preparation). 5) In collaboration with Dr. Egwuagu and colleagues in LI/NEI, we also published our recent observation that SOCS5, a critical immunosuppressive protein in the cellular signaling events may be used as a clinical marker for active uveitis and further used as prognostic marker for the clinical therapy. These results have been published in J. Autoimmunity and may have implications for linking cellular signaling events with clinical activities of uveitis patients. 6) In addition, we also made progress in translational studies in the following areas. A) In collaboration with a biotech company (Neurotech., Inc.), we tested an IL-10 secreting RPE cell implant in treating uveitis in EAU model. Preliminary data suggest that this implant may have potentials in treating EAU. B) In collaboration with NCI, we established a murine-humman B cell intraocular lymphoma model and showed that it could be used for therapeutic testing and for furter understanding molecular mechanisms of Primary Intraocular Lymphoma (PIOL). We showed that an immunotoxin that is specific for B cells (HA22) can eradicate lymphoma cells in this model, proposing that this immunotoxin can be used clinically for treating PIOL patients. (manuscript in preparation). Future emphasis: A) Clinically, in additon to autoimmune uveitis, we will focus on understanding the potential roles of immune mechanisms in the molecular pathogeneisis of Age-related Macular Degeneration (AMD) and Diabetic retinopathy. Recent findings of the role of complement factor H in AMD further support our intention to pursue in this direction. We have designed several flowcytometry protocols for screening AMD and diabetic patients. We have also adopted two diabetic murine models to complement human dtudies. We plan also to establish a high throughput SNP assay to complement our phenotyping studies. B) Mechanistic effects of daclizumab (humanized anti-CD25, anti-Tac, HAT) treatment on uveitis patients: Daclizumab, or humanized anti-CD25, or anti-Tac, or HAT, has been successful in treating non-infectious intermediate and posterior uveitis. Understanding the mechanisms of this therapy at the molecular level can facilitate and improve clinical treatment of autoimmune uveitis. We believe that these findings will have implications for other autoimmune disorders. Indeed, we have discovered a unqiue sub-population of cells from innate immune system that is induced by Daclizumab and may be beneficial to patients. We wish to continue our efforts on this track. C) Streamline molecular and cellular methodology and maximize windows that help reveal potential mechanisms for the diseases: The advantage of studying patient samples is its direct clinical relevance and potential impact on clinical diagnosis and therapy. But the challenges of clinical studies are the limitation of sample sources and quantity, inconsistency of patients' compliance, often difficulty to repeat the results, as well as influences of constantly changing environments that may alter the outcome of studies. One of the ways to minimize those factors is to streamline the methodologies that are used to examine patients' specimen so that multiple measurements will be performed simultaneously for a single specimen and mutually supportive data will be generated . We have made progress instandardizing methodology for analysis. We wish to continue to focus on this aspect of studies. D) Continuouslly collaborating with intramural as well as extramural scietists and industries. Our previous experience in collaborating with intramural scientists, e.g., LI and other labs in NEI, with NCI as well as with industries, e.g., Neurotech, Inc proved to be critical for our productivity. We wish to continue on this track and expand our collaborations with all who share interst with us in our ultimate goals, e.g., to further understand the molecular mechanisms and seek for efficient therapies for ocular inflammatory diseases.

National Institute of Health (NIH)
National Eye Institute (NEI)
Intramural Research (Z01)
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U.S. National Eye Institute
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Li, Zhuqing; Liu, Baoying; Maminishkis, Arvydas et al. (2008) Gene expression profiling in autoimmune noninfectious uveitis disease. J Immunol 181:5147-57
Li, Zhuqing; Mahesh, Sankaranarayana P; Shen, De Fen et al. (2006) Eradication of tumor colonization and invasion by a B cell-specific immunotoxin in a murine model for human primary intraocular lymphoma. Cancer Res 66:10586-93
Mahesh, Sankaranarayana P; Li, Zhuqing; Liu, Baoying et al. (2006) Expression of GITR ligand abrogates immunosuppressive function of ocular tissue and differentially modulates inflammatory cytokines and chemokines. Eur J Immunol 36:2128-38
Liu, Baoying; Li, Zhuqing; Mahesh, Sankaranarayana P et al. (2006) HTLV-1 infection of human retinal pigment epithelial cells and inhibition of viral infection by an antibody to ICAM-1. Invest Ophthalmol Vis Sci 47:1510-5
Li, Zhuqing; Lim, Wee Kiak; Mahesh, Sankaranarayana P et al. (2005) Cutting edge: in vivo blockade of human IL-2 receptor induces expansion of CD56(bright) regulatory NK cells in patients with active uveitis. J Immunol 174:5187-91
Egwuagu, Charles E; Yu, Cheng-Rong; Li, Zhuqing et al. (2005) SOCS5 mRNA levels in peripheral blood mononuclear cells (PBMC): a potential bio-marker for monitoring response of uveitis patients to Daclizumab therapy. J Autoimmun 24:39-46
Mahesh, S P; Li, Zhuqing; Buggage, R et al. (2005) Alpha tropomyosin as a self-antigen in patients with Behcet's disease. Clin Exp Immunol 140:368-75
Kim, Ben J; Li, Zhuqing; Fariss, Robert N et al. (2004) Constitutive and cytokine-induced GITR ligand expression on human retinal pigment epithelium and photoreceptors. Invest Ophthalmol Vis Sci 45:3170-6
Li, Zhuqing; Mahesh, Sankaranarayana P; Kim, Ben J et al. (2003) Expression of glucocorticoid induced TNF receptor family related protein (GITR) on peripheral T cells from normal human donors and patients with non-infectious uveitis. J Autoimmun 21:83-92
McDyer, John F; Li, Zhuqing; John, Susan et al. (2002) IL-2 receptor blockade inhibits late, but not early, IFN-gamma and CD40 ligand expression in human T cells: disruption of both IL-12-dependent and -independent pathways of IFN-gamma production. J Immunol 169:2736-46