Wakefield Denis, Clarke Daniel, McCluskey Peter
Faculty of Medicine, University of NSW Sydney, Kensington, NSW, Australia.
NSW Health Pathology and South Eastern Sydney, LHD, Sydney, NSW, Australia.
Front Immunol. 2021 Jan 5;11:608134. doi: 10.3389/fimmu.2020.608134. eCollection 2020.
There has been steady progress in understanding the pathogenesis, clinical features, and effective treatment of acute anterior uveitis (AU) over the past 5 years. Large gene wide association studies have confirmed that AU is a polygenic disease, with overlaps with the seronegative arthropathies and inflammatory bowel diseases, associations that have been repeatedly confirmed in clinical studies. The role of the microbiome in AU has received increased research attention, with recent evidence indicating that human leukocyte antigen B27 (HLA B27) may influence the composition of the gut microbiome in experimental animals. Extensive clinical investigations have confirmed the typical features of acute AU (AAU) and its response to topical, regional and systemic immunosuppressive treatment. Increased understanding of the role of cytokines has resulted in studies confirming the value of anti-cytokine therapy [anti-tumor necrosis factor (anti-TNF) and interleukin 6 (IL-6) therapy] in severe and recurrent cases of AAU, particularly in subjects with an associated spondyloarthopathy (SpA) and in juvenile idiopathic arthritis (JIA)-associated AAU.
在过去5年里，在理解急性前葡萄膜炎（AU）的发病机制、临床特征和有效治疗方面取得了稳步进展。大型全基因组关联研究已证实AU是一种多基因疾病，与血清阴性关节病和炎症性肠病存在重叠，这些关联在临床研究中已得到反复证实。微生物群在AU中的作用受到了越来越多的研究关注，最近有证据表明，人类白细胞抗原B27（HLA B27）可能会影响实验动物肠道微生物群的组成。广泛的临床研究证实了急性AU（AAU）的典型特征及其对局部、区域和全身免疫抑制治疗的反应。对细胞因子作用的进一步了解促使研究证实了抗细胞因子疗法[抗肿瘤坏死因子（抗TNF）和白细胞介素6（IL-6）疗法]在AAU严重和复发病例中的价值，特别是在伴有脊柱关节病（SpA）的患者以及青少年特发性关节炎（JIA）相关的AAU患者中。
