Foussat Arnaud, Gregoire Sylvie, Clerget-Chossat Nathalie, Terrada Celine, Asnagli Hélène, Lemoine François M, Klatzmann David, LeHoang Phuc, Forte Miguel, Bodaghi Bahram
1 Txcell SA, Valbonne, France .
2 Centre d'Immunologie et des Maladies Infectieuses (CIMI), Sorbonne Universités , Paris, France .
J Ocul Pharmacol Ther. 2017 May;33(4):278-284. doi: 10.1089/jop.2016.0165.
Uveitis is a sight-threatening primary intraocular inflammation of various origins in mainly young and active patients. Due to the absence of biomarkers in most of the cases, the current treatment of noninfectious entities remains nonspecific, using corticosteroids, conventional immunosuppressors, and more recently biological agents. Identification of regulatory T cells in different models of autoimmune uveitis together with the evaluation of this important subpopulation in different entities paved the way for new therapeutic strategies, in addition to exclusive pharmaceutical approaches. Upregulation of regulatory T cells induced by biological agents has been recently highlighted. Development of cell therapy in autoimmune diseases is at its stammering needing more experimental data and robust clinical trials to demonstrate safety and efficacy before larger developments. Specific or polyclonal Tregs may be used, but it is of utmost importance to determine the method of selection, the level of activation, and the route of administration. Mastering immune cell therapy remains a challenging goal in patients with autoimmune diseases, but it may significantly enlarge our therapeutic possibilities in severe and refractory situations.
葡萄膜炎是一种主要发生在年轻且活跃患者中的、起源各异的威胁视力的原发性眼内炎症。由于大多数情况下缺乏生物标志物,目前对非感染性葡萄膜炎的治疗仍然缺乏特异性,主要使用皮质类固醇、传统免疫抑制剂,以及最近的生物制剂。在不同的自身免疫性葡萄膜炎模型中鉴定调节性T细胞,以及在不同类型中评估这一重要亚群,为除了单纯药物治疗方法之外的新治疗策略铺平了道路。生物制剂诱导的调节性T细胞上调最近受到了关注。自身免疫性疾病细胞治疗的发展尚处于起步阶段,在更大规模发展之前,需要更多的实验数据和有力的临床试验来证明其安全性和有效性。可以使用特异性或多克隆调节性T细胞,但确定选择方法、激活水平和给药途径至关重要。掌握免疫细胞治疗对于自身免疫性疾病患者来说仍然是一个具有挑战性的目标,但它可能会显著扩大我们在严重和难治性情况下的治疗选择。