Dini Gianluca, Dell'Isola Giovanni Battista, Beccasio Alfredo, Di Cara Giuseppe, Verrotti Alberto, Cagini Carlo
Department of Pediatrics, University of Perugia, Perugia, Italy.
Department of Medicine and Surgery, Section of Ophthalmology, University of Perugia, Perugia, Italy.
Front Ophthalmol (Lausanne). 2022 Aug 15;2:954901. doi: 10.3389/fopht.2022.954901. eCollection 2022.
Juvenile idiopathic arthritis (JIA) is the most frequent rheumatic disease of childhood and uveitis is its most common extra-articular manifestation. JIA-associated uveitis (JIA-U) is one of the main causes of visual impairment in children and represents a major challenge for pediatrician and ophthalmologist, due to its insidious onset and sight-threatening complications. Topical glucocorticoids are the first line of treatment, followed by conventional disease-modifying anti-rheumatic drugs (DMARDs), usually methotrexate (MTX). In recent years, new biological drugs targeting specific molecules involved in disease pathogenesis, have significantly improved the prognosis of the disease, especially for cases refractory to conventional therapies. In this review we discuss the role of biological agents in JIA-U, focusing on cytokine blockers and cell-targeted therapies aimed to control ocular inflammation.
幼年特发性关节炎（JIA）是儿童时期最常见的风湿性疾病，葡萄膜炎是其最常见的关节外表现。JIA相关葡萄膜炎（JIA-U）是儿童视力损害的主要原因之一，由于其发病隐匿且有视力威胁性并发症，对儿科医生和眼科医生来说是一项重大挑战。局部糖皮质激素是一线治疗药物，其次是传统的改善病情抗风湿药（DMARDs），通常是甲氨蝶呤（MTX）。近年来，针对疾病发病机制中特定分子的新型生物药物显著改善了该病的预后，尤其是对传统治疗难治的病例。在本综述中，我们讨论生物制剂在JIA-U中的作用，重点关注旨在控制眼部炎症的细胞因子阻滞剂和细胞靶向疗法。
