Brzheskiy V V
Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
Vestn Oftalmol. 2023;139(2):95-103. doi: 10.17116/oftalma202313902195.
In recent years, anti-inflammatory therapy has become a significant part of the complex approach to treatment of patients with dry eye syndrome (DES), with cyclosporine preparations becoming increasingly important in the structure of the therapy. Taking into account the immunosuppressive effect of cyclosporine A, which is realized through hindering the activation of T-lymphocytes in the tissues of the ocular surface, its topical application in DES has a pronounced pathogenetic focus. Numerous clinical studies have shown that instillations of cyclosporine into the conjunctival cavity contribute to an increase in total tear production, as well as recovery of the density of goblet cells in the conjunctiva of DES patients. The positive effect of cyclosporine A instillations has been convincingly demonstrated in the complex therapy of patients with vernal and atopic corneal conjunctivitis, Thygeson's superficial punctate keratitis, autoimmune keratitis, meibomian gland dysfunction, etc. However, one significant problem associated with cyclosporine A instillations is the irritating effect of the drug. That prompted the development of a drug that is safe and tolerable during instillations into the conjunctival cavity - preservative-free 0.1% cyclosporine A labelled Ikervis (Santen, Japan). The drug carrier is artificial tear Cationorm (Santen), which has an advantage of stabilizing the tear film and protecting the ocular surface from the irritating effect of cyclosporine. According to numerous clinical studies, Ikervis instillations can improve the effectiveness of complex therapy in patients with DES (especially secondary to Sjögren syndrome, Stevens-Johnson syndrome, graft-versus-host disease), with allergic diseases of the cornea and conjunctiva (spring, atopic corneal conjunctivitis), with corneal transplant disease, and other similar conditions. The high efficacy and safety of Ikervis constitute the reason to recommend it for wide clinical use.
近年来，抗炎治疗已成为干眼症（DES）患者综合治疗方法的重要组成部分，环孢素制剂在治疗结构中变得越来越重要。考虑到环孢素A的免疫抑制作用是通过阻碍眼表组织中T淋巴细胞的激活来实现的，其在DES中的局部应用具有明显的致病针对性。大量临床研究表明，将环孢素滴入结膜囊有助于增加总泪液分泌，以及恢复DES患者结膜中杯状细胞的密度。环孢素A滴眼在春季角结膜炎、特应性角结膜炎、蒂格森浅层点状角膜炎、自身免疫性角膜炎、睑板腺功能障碍等患者的综合治疗中已得到令人信服的证实。然而，与环孢素A滴眼相关的一个重大问题是药物的刺激作用。这促使人们开发一种在滴入结膜囊时安全且可耐受的药物——不含防腐剂的0.1%环孢素A，商品名为Ikervis（日本参天制药）。药物载体是人工泪液Cationorm（参天制药），它具有稳定泪膜和保护眼表免受环孢素刺激作用的优点。根据大量临床研究，Ikervis滴眼可提高DES患者（尤其是继发于干燥综合征、史蒂文斯-约翰逊综合征、移植物抗宿主病）、角膜和结膜过敏性疾病（春季、特应性角结膜炎）、角膜移植疾病及其他类似病症患者综合治疗的有效性。Ikervis的高疗效和安全性构成了推荐其广泛临床应用的理由。
