葡萄膜炎分子机制及其生物治疗最新进展

Advances in Molecular Mechanism and Biological Therapy of Uveitis

葡萄膜炎是一种眼内炎症性疾病,其病因为传染性或自身免疫性,是世界可预防盲的主要原因之一。其病理改变为眼睛中持续产生炎症细胞、具有细胞毒性的细胞因子和其他免疫调节蛋白。该病最主要的治疗目标是下调免疫反应,减轻炎症反应,保持眼部结构的完整性,避免眼部永久性损伤。目前的治疗方法主要是在局部或全身皮质类固醇使用的基础上联合或不联合免疫调节药物。这些药物有严重的不良反应,所以需要我们进一步研究开发毒性较低的更具有针对性的葡萄膜炎治疗方式。本综述描述了葡萄膜炎的病理生理学,调节葡萄膜炎发生和发展的分子机制,并总结了治疗这类潜在致盲性疾病的新策略中的新兴生物制剂。

Uveitis is a heterogenous group of intraocular inflammatory disorders which is one of the leading causes of preventable blindness worldwide. It is classified as infectious or autoimmune etiology. Pathology of uveitis is the presence of inflammatory cells, sustained production of cytotoxic cytokines and other immuneregulatory proteins in the eye. The main therapeutic goals are to down- regulate the immune response, reduce inflammation, preserve the integrity of the ocular architecture and eventually attain complete remission, thereby avoiding permanent cumulative damage. Current therapy includes topical or systemic corticosteroid with or without conventional immunomodulatory drugs. However, serious adverse effects of these drugs impel us to find less toxic and more specific therapies for uveitis. With the significant progress in our understanding of the immunopathological pathways that drive intraocular inflammation, this review summarizes the pathogensis and concludes with emerging strategies with biologic agents for the treatment of uveitis.