University of Chicago, Department of Internal Medicine , 5841 South Maryland Ave MC 7082, Chicago, IL 60637 , USA.
Expert Opin Drug Metab Toxicol. 2014 Apr;10(4):543-9. doi: 10.1517/17425255.2014.884070. Epub 2014 Feb 3.
Topical calcineurin (Cn) inhibitors delivered via ophthalmic drop is emerging as a potential treatment for severe, immune-mediated forms of allergic conjunctivitis, such as vernal keratoconjunctivitis, atopic keratoconjunctivitis and giant papillary conjunctivitis.
This article is based on a comprehensive literature search, with information taken from meta-analyses, systematic reviews, treatment guidelines and clinical studies in children and adults. The articles that have been selected evaluate the use of topical Cn inhibitors and their role in the treatment of allergic conjunctivitis.
Ophthalmic topical Cn inhibitors have been shown to be safe for short-term use, with minimal systemic absorption and toxicity. For patients with severe, refractory forms of allergic conjunctivitis, topical Cn inhibitors offer a promising treatment option and an alternative to steroidal therapies. The safety profile and efficacy data for topical cyclosporine are more robust compared to that of tacrolimus and pimecrolimus, although larger trials will be needed for all three agents. With more randomized controlled trials involving larger sample sizes and long-term follow-up to establish both efficacy and safety, ophthalmic Cn inhibitors offer exciting treatment possibilities for the prevention of morbidity associated with refractory allergic conjunctivitis.
局部钙调神经磷酸酶（Cn）抑制剂通过滴眼剂给药，正在成为治疗严重免疫介导性过敏结膜炎的潜在方法，例如春季角结膜炎、特应性角结膜炎和巨大乳头性结膜炎。
本文基于全面的文献检索，信息取自荟萃分析、系统评价、治疗指南和儿童及成人的临床研究。所选的文章评估了局部 Cn 抑制剂的使用及其在过敏结膜炎治疗中的作用。
局部滴眼用 Cn 抑制剂短期使用安全，全身吸收和毒性极小。对于严重、难治性过敏结膜炎患者，局部 Cn 抑制剂提供了一种有前途的治疗选择，可替代类固醇疗法。与他克莫司和吡美莫司相比，环孢素的安全性和疗效数据更为可靠，尽管所有三种药物都需要更大规模的试验。随着更多涉及更大样本量和长期随访的随机对照试验，以确定疗效和安全性，眼部 Cn 抑制剂为预防难治性过敏结膜炎相关发病率提供了令人兴奋的治疗可能性。
