Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Ophthalmology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Ocul Immunol Inflamm. 2024 Sep;32(7):1150-1154. doi: 10.1080/09273948.2023.2182325. Epub 2023 Feb 28.
Severe uveitis is a rare complication of interleukin-4 receptor alpha blocking by dupilumab in topic dermatitis (AD) patients. The aim of this study was to describe five moderate-to-severe AD patients who developed uveitis during dupilumab treatment and to compare the proteomic profile of aqueous humor (AqH) of dupilumab-associated uveitis (n=3/5 available samples) with non-infectious uveitis (n=27) and cataract controls (n=11). Included patients were treated at the University Medical Center Utrecht (the Netherlands). Active dupilumab-associated uveitis complicated by serous detachment, cystoid macular edema, or secondary glaucoma developed within a median of 6.0 months (interquartile range 2.3-16.5 months) after starting dupilumab. Uveitis resolved after discontinuation of dupilumab and/or treatment with local or systemic corticosteroids. Proteomic profiling of AqH revealed that the molecular profile of dupilumab-associated uveitis resembled that of non-infectious uveitis. In conclusion, dupilumab-associated uveitis is a severe adverse event of dupilumab therapy, requiring urgent referral to an ophthalmologist.
严重葡萄膜炎是白细胞介素-4 受体α阻断剂度普利尤单抗在特应性皮炎（AD）患者中引发的罕见并发症。本研究旨在描述 5 名在度普利尤单抗治疗期间发生葡萄膜炎的中重度 AD 患者，并比较度普利尤单抗相关葡萄膜炎（n=3/5 可用样本）与非感染性葡萄膜炎（n=27）和白内障对照（n=11）的房水（AqH）蛋白质组特征。纳入的患者在乌得勒支大学医学中心（荷兰）接受治疗。开始使用度普利尤单抗后中位 6.0 个月（2.3-16.5 个月）内出现并发浆液性视网膜脱离、囊样黄斑水肿或继发性青光眼的活动性度普利尤单抗相关葡萄膜炎。停用度普利尤单抗和/或局部或全身皮质类固醇治疗后，葡萄膜炎得到缓解。AqH 的蛋白质组分析显示，度普利尤单抗相关葡萄膜炎的分子特征与非感染性葡萄膜炎相似。总之，度普利尤单抗相关葡萄膜炎是度普利尤单抗治疗的严重不良事件，需要紧急转介给眼科医生。
