Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Ophthalmology, Clinical Research Institute, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan.
Front Immunol. 2020 Jul 3;11:1431. doi: 10.3389/fimmu.2020.01431. eCollection 2020.
In the twentieth century, a conspicuous lack of effective treatment strategies existed for managing several retinal disorders, including age-related macular degeneration; diabetic retinopathy (DR); retinopathy of prematurity (ROP); retinitis pigmentosa (RP); uveitis, including Behçet's disease; and vitreoretinal lymphoma (VRL). However, in the first decade of this century, advances in biomedicine have provided new treatment strategies in the field of ophthalmology, particularly biologics that target vascular endothelial growth factor or tumor necrosis factor (TNF)-α. Furthermore, clinical trials on gene therapy specifically for patients with autosomal recessive or X-linked RP have commenced. The overall survival rates of patients with VRL have improved, owing to earlier diagnoses and better treatment strategies. However, some unresolved problems remain such as primary or secondary non-response to biologics or chemotherapy, and the lack of adequate strategies for treating most RP patients. In this review, we provide an overview of the immunological mechanisms of the eye under normal conditions and in several retinal disorders, including uveitis, DR, ROP, RP, and VRL. In addition, we discuss recent studies that describe the inflammatory responses that occur during the course of these retinal disorders to provide new insights into their diagnosis and treatment.
在二十世纪，对于几种视网膜疾病的治疗策略仍然存在显著的不足，包括年龄相关性黄斑变性；糖尿病性视网膜病变（DR）；早产儿视网膜病变（ROP）；色素性视网膜炎（RP）；葡萄膜炎，包括贝切特病；以及玻璃体视网膜淋巴瘤（VRL）。然而，在本世纪的第一个十年中，生物医学的进步为眼科领域提供了新的治疗策略，特别是针对血管内皮生长因子或肿瘤坏死因子（TNF）-α的生物制剂。此外，针对常染色体隐性或 X 连锁 RP 患者的基因治疗临床试验已经开始。由于早期诊断和更好的治疗策略，VRL 患者的总生存率得到了提高。然而，一些未解决的问题仍然存在，例如对生物制剂或化疗的原发性或继发性无反应，以及缺乏治疗大多数 RP 患者的适当策略。在这篇综述中，我们概述了正常情况下和几种视网膜疾病（包括葡萄膜炎、DR、ROP、RP 和 VRL）中眼睛的免疫学机制。此外，我们还讨论了最近的研究，这些研究描述了这些视网膜疾病过程中发生的炎症反应，为其诊断和治疗提供了新的见解。
