Rowan-Virtua School of Medicine, Stratford, New Jersey.
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Allergy Clin Immunol. 2024 Oct 1;24(5):360-367. doi: 10.1097/ACI.0000000000001017. Epub 2024 Jul 24.
Cyclosporine is a versatile immunomodulatory drug commonly employed in modern medicine. Although cyclosporine was initially used to prevent solid organ transplant rejection, its indications have extended to treat many inflammatory or autoimmune diseases. Cyclosporin is available for use in oral, intravenous, and topical forms, including eye drops to treat corneal and ocular surface conditions. It is naturally advantageous to administer cyclosporin directly into the eye, avoiding potential and dose limiting systemic adverse effects. However, the transition from systemic to topical administration has been a challenging one. This report reviews the evolution of ophthalmic cyclosporine treatment and explores its clinical impacts and future research directions.
Latest advancements in formulations - from oil-based solutions to nanomicelle and gel systems and waterless formulations - have improved the therapeutic efficacy and tolerability of topically applied cyclosporine, demonstrating greater effectiveness in treating ocular surface parameters compared to oil-based solution.
Cyclosporine continues to be a safe and effective immunomodulatory drug in the field of ophthalmology to treat various chronic inflammatory ocular surface diseases and dry eye. Currently, there are several commercially available topical preparations available for ophthalmic use each with unique formulation and clinical outcomes.
环孢素是一种用途广泛的免疫调节剂，在现代医学中被广泛应用。尽管环孢素最初用于预防实体器官移植排斥反应，但它的适应证已扩展到治疗许多炎症或自身免疫性疾病。环孢素可口服、静脉注射和局部使用，包括滴眼剂，用于治疗角膜和眼表疾病。将环孢素直接施用于眼睛具有天然优势，可以避免潜在的、剂量限制的全身不良反应。然而，从全身给药到局部给药的转变一直具有挑战性。本报告回顾了眼科环孢素治疗的发展，并探讨了其临床影响和未来的研究方向。
制剂的最新进展——从油基溶液到纳米胶束和凝胶系统以及无水制剂——提高了局部应用环孢素的治疗效果和耐受性，与油基溶液相比，在治疗眼表参数方面更有效。
环孢素在眼科领域继续作为一种安全有效的免疫调节剂，用于治疗各种慢性炎症性眼表疾病和干眼症。目前，有几种市售的眼科用局部制剂，每种制剂都有独特的配方和临床效果。
