The adaptive immune system in the retina of diabetics

Surv Ophthalmol. 2025 Mar-Apr;70(2):241-254. doi: 10.1016/j.survophthal.2024.11.005. Epub 2024 Nov 19.

Abstract

As the prevalence of diabetes mellitus increases each year, its most common microvascular complication, diabetic retinopathy (DR), is also on the rise. DR is now regarded as an inflammatory disease in which innate immunity plays a crucial role, and a large number of innate immune cells with associated cytokines are involved in the pathologic process of DR. The role of adaptive immunity in DR is seldom mentioned, probably due to the general perception of the immune privileged environment of the retina; however, in recent years there has been a gradual increase in research on the role of adaptive immunity in DR, and with the discovery of the retinal lymphatic system, it seems that the role of adaptive immunity can no longer be ignored. Here, we discuss the immunosuppressive environment of the retina, the phenomenon and potential mechanisms of lymphocyte infiltration in DR, and the role of the adaptive immune system in the diabetic retina, which may point the way for future research.

Keywords: Adaptive immunity; Diabetes; Diabetic complications; Diabetic retinopathy; Inflammation; T cell; lymphocytes.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity*
  • Diabetic Retinopathy* / immunology
  • Humans
  • Immunity, Innate
  • Retina / immunology