Chang John H, McCluskey Peter J, Wakefield Denis
Laboratory of Ocular Immunology, Inflammatory Diseases Research Unit, School of Medical Sciences, University of New South Wales, Sydney; Department of Ophthalmology, St. Vincent's Hospital, Sydney.
Surv Ophthalmol. 2005 Jul-Aug;50(4):364-88. doi: 10.1016/j.survophthal.2005.04.003.
Acute anterior uveitis is the most common form of uveitis. HLA-B27-associated acute anterior uveitis is a distinct clinical entity that has wide-ranging medical significance due to its ocular, systemic, immunologic, and genetic features. The association between HLA-B27 and the spectrum of HLA-B27-associated inflammatory diseases remains one of the strongest HLA-disease associations known to date. This review examines acute anterior uveitis with particular focus on HLA-B27-associated acute anterior uveitis, including the epidemiology, immunopathology, association with HLA-B27 and its subtypes, clinical features, complications, prognosis, and potential new therapies such as anti-TNFalpha therapy and oral HLA-B27-peptide tolerance. There have been substantial recent advances in both clinical and basic scientific research in this field, including studies of the various animal models of acute anterior uveitis and the HLA-B27 transgenic animals, and these are summarized in this review. To the ophthalmologist, HLA-B27-associated acute anterior uveitis is an important clinical entity that is common, afflicts relatively young patients in their most productive years, and is associated with significant ocular morbidity due to its typically recurrent attacks of inflammation and its potentially vision-threatening ocular complications. Furthermore, to the ophthalmologist and the internist, HLA-B27-associated acute anterior uveitis is also of systemic importance due to its significant association with extraocular inflammatory diseases.
急性前葡萄膜炎是葡萄膜炎最常见的形式。HLA - B27相关性急性前葡萄膜炎是一种独特的临床实体，因其眼部、全身、免疫和遗传特征而具有广泛的医学意义。HLA - B27与HLA - B27相关性炎症性疾病谱之间的关联仍是迄今为止已知最强的HLA - 疾病关联之一。本综述探讨急性前葡萄膜炎，特别关注HLA - B27相关性急性前葡萄膜炎，包括流行病学、免疫病理学、与HLA - B27及其亚型的关联、临床特征、并发症、预后以及潜在的新疗法，如抗TNFα疗法和口服HLA - B27肽耐受性。该领域近期在临床和基础科学研究方面都取得了重大进展，包括对急性前葡萄膜炎各种动物模型和HLA - B27转基因动物的研究，本综述对此进行了总结。对于眼科医生来说，HLA - B27相关性急性前葡萄膜炎是一种重要的临床实体，它很常见，在患者最具生产力的年龄段折磨相对年轻的患者，并且由于其典型的炎症反复发作和潜在的威胁视力的眼部并发症而导致显著的眼部发病率。此外，对于眼科医生和内科医生来说，HLA - B27相关性急性前葡萄膜炎因其与眼外炎症性疾病的显著关联而在全身方面也具有重要意义。
