Immunopathology Section, Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, MD 20892-1857, USA.
Eye (Lond). 2011 Feb;25(2):127-39. doi: 10.1038/eye.2010.196. Epub 2010 Dec 24.
Although age-related macular degeneration (AMD) is not a classic inflammatory disease like uveitis, inflammation has been found to have an important role in disease pathogenesis and progression. Innate immunity and autoimmune components, such as complement factors, chemokines, cytokines, macrophages, and ocular microglia, are believed to be heavily involved in AMD development. Targeting these specific inflammatory molecules has recently been explored in an attempt to better understand and treat AMD. Although antivascular endothelial growth factor therapy is the first line of defence against neovascular AMD, anti-inflammatory agents such as corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), immunosuppressive agents (eg, methotrexate and rapamycin), and biologics (eg, infliximab, daclizumab, and complement inhibitors) may provide an adjunct or alternative mechanism to suppress the inflammatory processes driving AMD progression. Further investigation is required to evaluate the long-term safety and efficacy of these drugs for both neovascular and non-neovascular AMD.
虽然年龄相关性黄斑变性(AMD)不是像葡萄膜炎那样的经典炎症性疾病,但炎症在疾病发病机制和进展中被发现具有重要作用。先天免疫和自身免疫成分,如补体因子、趋化因子、细胞因子、巨噬细胞和眼部小胶质细胞,被认为与 AMD 的发展密切相关。最近,人们探索了针对这些特定炎症分子的靶向治疗方法,以期更好地理解和治疗 AMD。尽管抗血管内皮生长因子治疗是治疗新生血管性 AMD 的一线治疗方法,但皮质类固醇、非甾体抗炎药(NSAIDs)、免疫抑制剂(如甲氨蝶呤和雷帕霉素)和生物制剂(如英夫利昔单抗、达珠单抗和补体抑制剂)等抗炎药物可能提供一种辅助或替代机制来抑制推动 AMD 进展的炎症过程。需要进一步研究来评估这些药物对新生血管性和非新生血管性 AMD 的长期安全性和疗效。