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发展中国家葡萄膜炎的全身免疫抑制疗法。

Systemic immunosuppressive therapies for uveitis in developing countries.

作者信息

Agrawal Hitesh, Doan Hien, Pham Brandon, Khosla Amit, Babu Manohar, McCluskey Peter, Nguyen Quan Dong, Sangwan Virender, Reddy Subhakar, Sawhney Sujata, Tyagi Mudit

机构信息

L V Prasad Eye Institute, Hyderabad, Telangana, India.

Byers Eye Institute, Palo Alto, CA, USA.

出版信息

Indian J Ophthalmol. 2020 Sep;68(9):1852-1862. doi: 10.4103/ijo.IJO_1548_20.

Abstract

There are multiple approaches to inhibit inflammatory molecules and pathways in noninfectious uveitis. The cornerstone of local and systemic anti-inflammatory treatment is corticosteroid therapy. Corticosteroids remain the most potent and efficacious drugs for treating intraocular inflammation. However, their long-term use is limited by their medium- and long-term side effects, which are a major concern. The approach taken to limit corticosteroid side effects is to introduce steroid-sparing agents that suppress the inflammatory pathways and immune response differently than corticosteroids. There are several classes of such drugs that are affordable, effective, and generally well-tolerated. Relatively recently, an increasing range of biologic agents has become available to treat intraocular inflammation. However, the relatively expensive cost of these therapies limits their use in the developing world. This systemic review aimst to discuss the use of corticosteroids and different immunosuppressive regimens in the management of various uveitides.

摘要

在非感染性葡萄膜炎中,有多种方法可抑制炎症分子和炎症途径。局部和全身抗炎治疗的基石是皮质类固醇疗法。皮质类固醇仍然是治疗眼内炎症最有效且效力最强的药物。然而,它们的长期使用受到其中长期副作用的限制,这是一个主要问题。限制皮质类固醇副作用的方法是引入与皮质类固醇不同的、能够抑制炎症途径和免疫反应的类固醇节省剂。有几类这样的药物价格实惠、效果良好且通常耐受性较好。相对较新的是,越来越多的生物制剂可用于治疗眼内炎症。然而,这些疗法相对昂贵的成本限制了它们在发展中国家的使用。本系统评价旨在讨论皮质类固醇和不同免疫抑制方案在各种葡萄膜炎治疗中的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23f4/7690522/c17b8eed10fe/IJO-68-1852-g001.jpg

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