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[眼部过敏的基础免疫学与当前治疗理念]

[Basic immunology and current therapeutic concepts in ocular allergy].

作者信息

Gehlsen U, Cursiefen C, Steven P

机构信息

Zentrum für Augenheilkunde, Uniklinik Köln.

出版信息

Klin Monbl Augenheilkd. 2014 May;231(5):490-5. doi: 10.1055/s-0034-1368337. Epub 2014 May 5.

Abstract

BACKGROUND

Ocular allergy belongs to the most common ocular diseases globally. Following clinical phenotype and immunopathogenesis different forms of allergy are distinguished, which require different forms of therapeutic approach. This manuscript reviews the basic immunological processes involved in the development of ocular allergies and current and future therapeutic approaches.

METHODS

Results of a literature search in PubMed and our own clinical and experimental experience are presented.

RESULTS

In the immunopathogenesis of ocular allergy different immune cells such as dendritic cells, B-cells, T-cells, mast cells, eosinophils and regulatory T-cells are involved. Therapeutic approaches focus on either relief of symptoms using antihistamins or mast cell stabilisers or combinations of both. In severe cases steroids or calcineurin inhibitors are used.

DISCUSSION

Despite great progress in the investigation of ocular allergy in the past decade several open questions remain, such as the relation of ocular allergy with dry eye disease. Future therapeutic approaches will likely be based on recently identified new aspects such as lymphangiogenesis and will allow better and potentially causal treatment of ocular allergy.

摘要

背景

眼部过敏是全球最常见的眼部疾病之一。根据临床表型和免疫发病机制,可区分出不同形式的过敏,这需要不同形式的治疗方法。本文综述了眼部过敏发生过程中涉及的基本免疫过程以及当前和未来的治疗方法。

方法

介绍了在PubMed上进行文献检索的结果以及我们自己的临床和实验经验。

结果

在眼部过敏的免疫发病机制中,涉及多种免疫细胞,如树突状细胞、B细胞、T细胞、肥大细胞、嗜酸性粒细胞和调节性T细胞。治疗方法主要集中在使用抗组胺药或肥大细胞稳定剂缓解症状,或两者联合使用。在严重病例中,使用类固醇或钙调神经磷酸酶抑制剂。

讨论

尽管在过去十年中眼部过敏的研究取得了很大进展,但仍有几个悬而未决的问题,如眼部过敏与干眼病的关系。未来的治疗方法可能基于最近发现的新方面,如淋巴管生成,这将使眼部过敏的治疗更好,甚至可能达到病因治疗的效果。

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