Wirostko E, Johnson L, Wirostko B
Hepatogastroenterology. 1987 Apr;34(2):90-3.
Idiopathic Uveitis (IU) may occur as either an isolated ocular disease or with other systemic diseases such as Crohn's Disease (CD). As many as 33% of CD patients demonstrate IU, and frequently their gut and IU course and severity are similar. Rifampin produces remissions of isolated IU, and Rifampin has been used to treat gut CD with varying success. In this investigation 4 CD patients, whose gut but not IU had partially responded to corticosteroids, the addition of Rifampin was associated with improvement in both their CD Activity Index and IU, allowing steroid discontinuation; Rifampin withdrawal was associated with exacerbations of both gut disease and IU; and re-institution of Rifampin was associated with another gut and IU disease remission. Since mouse ocular and systemic inflammatory disease producing non-cultivatable ultrastructurally unusual bacteria are commonly found within isolated chronic IU vitreous polymorphonuclear (PMN) leukocytes, a search for these bacteria in CD eye and gut disease seems justified, as the beneficial results of Rifampin in this study may have been an antimicrobial action on these bacteria.
特发性葡萄膜炎（IU）可能作为一种孤立的眼部疾病出现，也可能与其他全身性疾病如克罗恩病（CD）同时发生。多达33%的CD患者会出现IU，而且他们的肠道疾病和IU的病程及严重程度通常相似。利福平可使孤立性IU病情缓解，并且利福平已被用于治疗肠道CD，但效果各异。在本研究中，4例肠道疾病对皮质类固醇部分有反应但IU无反应的CD患者，加用利福平后其CD活动指数和IU均有所改善，从而得以停用类固醇；停用利福平与肠道疾病和IU病情加重相关；重新使用利福平则与肠道疾病和IU病情再次缓解相关。由于在孤立性慢性IU玻璃体多形核（PMN）白细胞中常见产生不可培养的超微结构异常细菌的小鼠眼部和全身性炎症性疾病，因此在CD眼部和肠道疾病中寻找这些细菌似乎是合理的，因为本研究中利福平的有益效果可能是对这些细菌的抗菌作用。
