Susan G. Elner, MD

Research Areas

• Clinical Trials - Retina
  • PeriOcular and INTravitreal corticosteroids for uveitic macular edema trial (POINT)

Research Summary

Mechanisms of ocular inflammation and angiogenesis, specifically the role and modulation of cytokines and cell adhesion molecules in uveitis; angiogenesis in diseases such as proliferative diabetic retinopathy, proliferative vitreoretinopathy, and age-related macular degeneration

Inflammation plays an important role in many eye diseases that are leading causes of blindness in the United States. Ocular infections, injury, uveitis, corneal graft rejection, proliferative vitreoretinopathy, retinal detachment, macular degeneration, and diabetic retinopathy all have in common the mobilization of white blood cells into diseased eye tissues and the production of inflammatory mediators. To investigate how inflammation is mediated in the eye, Drs. Susan and Victor Elner have been studying pro-inflammatory mediators (cytokines) and white blood cell adhesion molecules that are expressed by various types of ocular cells. They have shown that retinal cells may produce interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1), cytokines that attract and activate white blood cells during inflammation. One of these cytokines, IL-8, also has the ability to induce abnormal new blood vessel growth and cause retinal cells to produce peroxides and superoxides, which may further damage diseased tissue. The elners have identified another cytokine, IP-10, in ocular cells and disease. In contrast to IL-8, IP-10 can prevent new blood vessel growth, particularly blood vessel growth induced by IL-8. They are currently studying the role of IL-8 and IP-10 in diseases such as diabetes in which new blood growth may lead to vision loss. In addition, cell-cell adhesion between white blood cells and retinal cells may produce very high levels of IL-8 and MCP-1, exacerbating this inflammatory process.

In recent experiments the Elners have shown that another cytokine, interleukin-10, is able to inhibit the increase of IL-8 and MCP-1 levels, and lessen their destructive effects in corneas infected with Herpes Simplex Virus 1. Their investigation of these cellular mechanisms will help direct the development of therapeutic interventions aimed at the inflammatory cell component of many common and serious eye diseases.