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治疗白塞病相关性葡萄膜炎的生物疗法:超越 TNF-α 阻断的叙述性综述。

Biological therapies for the treatment of Behçet's disease-related uveitis beyond TNF-alpha blockade: a narrative review.

机构信息

Rheumatology Unit, Policlinico "Le Scotte", Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, University of Siena, viale Bracci 1, 53100, Siena, Italy.

Institute of Pediatrics, Periodic Fever Research Center, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy.

出版信息

Rheumatol Int. 2018 Jan;38(1):25-35. doi: 10.1007/s00296-017-3775-5. Epub 2017 Jul 27.

Abstract

Intraocular inflammation is one of the more relevant complications of Behçet's disease (BD), which tends to respond poorly to different medications. The ocular histopathologic changes are basically identical to those occurring in other organs and consist in a necrotizing leukocytoclastic obliterative vasculitis, which is probably immune complex-mediated and affects both arteries and veins of all sizes. There are growing evidences showing the potential role of biologic agents other than anti-tumor necrosis factor (TNF)-α agents in the management of ocular-BD, which have been collected in this review, including interleukin-1 and interleukin-6 blockade, secukinumab, ustekinumab, daclizumab, rituximab, and alemtuzumab. Further large studies are needed to fully elucidate and establish the clinical efficacy of these different tools in the refractory ocular manifestations of BD.

摘要

眼内炎症是 Behçet 病(BD)较相关的并发症之一,往往对不同药物反应不佳。眼部组织病理学改变基本与其他器官相同,表现为坏死性白细胞碎裂性闭塞性血管炎,可能由免疫复合物介导,影响所有大小的动脉和静脉。越来越多的证据表明,除了抗肿瘤坏死因子(TNF)-α 药物以外,生物制剂在治疗眼 BD 方面具有潜在作用,本综述中收集了这些证据,包括白介素-1 和白介素-6 阻断剂、司库奇尤单抗、乌司奴单抗、达利珠单抗、利妥昔单抗和阿仑单抗。需要进一步的大型研究来充分阐明和确定这些不同工具在 BD 难治性眼部表现中的临床疗效。

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