New Pharmacological Strategies for the Treatment of Non-Infectious Uveitis. A Minireview

Valenzuela, Rodrigo; Flores, Iván; Urrutia, Beatriz; Fuentes, Fernanda; Sabat, Pablo; Llanos, Carolina; Cuitiño, Loreto; Urzua, Cristhian A.

doi:10.3389/fphar.2020.00655

Cited by 22 publications

(19 citation statements)

References 85 publications

(126 reference statements)

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“…Systemic corticosteroids (CSs) (prednisolone) are the mainstay of clinical management of VKH, with evidence endorsing the use of high doses at early phases resulting in shorter treatment periods, reduced disease severity, and better subclinical manifestations ( Chee et al, 2007 ; Jap et al, 2008 ; Kitaichi et al, 2008 ; Kawaguchi et al, 2010 ), whereas CS administration for at least 6 months is key to reduce the risk of recurrence ( Lai et al, 2009 ; Errera et al, 2011 ). CS therapy is known to have several side effects, including systemic (diabetes, Cushing syndrome, osteoporosis) and eye-related features (cataract, glaucoma, visual impairment) ( Valenzuela et al, 2020b ).…”

Section: Vogt–koyanagi–harada Diseasementioning

confidence: 99%

“…Biologics have been introduced in uveitis management, and guidelines recommend them upon systemic CS/IMT treatment failure ( Rosenbaum et al, 2019 ; Valenzuela et al, 2020b ). Studies have shown that the use of adalimumab [anti-tumor necrosis factor α (TNF-α) antibody] ( Couto et al, 2018 ; Hiyama et al, 2021 ) and rituximab (anti-CD20 antibody) ( Abu El-Asrar et al, 2020 ) improves visual acuity, alleviates inflammation, and allows for CS tapering.…”

Section: Vogt–koyanagi–harada Diseasementioning

confidence: 99%

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miRNA Landscape in Pathogenesis and Treatment of Vogt–Koyanagi–Harada Disease

Vega-Tapia

Bustamante

Valenzuela

et al. 2021

Front. Cell Dev. Biol.

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miRNAs, one of the members of the noncoding RNA family, are regulators of gene expression in inflammatory and autoimmune diseases. Changes in miRNA pool expression have been associated with differentiation of CD4+ T cells toward an inflammatory phenotype and with loss of self-tolerance in autoimmune diseases. Vogt–Koyanagi–Harada (VKH) disease is a chronic multisystemic pathology, affecting the uvea, inner ear, central nervous system, and skin. Several lines of evidence support an autoimmune etiology for VKH, with loss of tolerance against retinal pigmented epithelium-related self-antigens. This deleterious reaction is characterized by exacerbated inflammation, due to an aberrant TH1 and TH17 polarization and secretion of their proinflammatory hallmark cytokines interleukin 6 (IL-6), IL-17, interferon γ, and tumor necrosis factor α, and an impaired CD4+ CD25high FoxP3+ regulatory T cell function. To restrain inflammation, VKH is pharmacologically treated with corticosteroids and immunosuppressive drugs as first and second line of therapy, respectively. Changes in the expression of miRNAs related to immunoregulatory pathways have been associated with VKH development, whereas some genetic variants of miRNAs have been found to be risk modifiers of VKH. Furthermore, the drugs commonly used in VKH treatment have great influence on miRNA expression, including those miRNAs associated to VKH disease. This relationship between response to therapy and miRNA regulation suggests that these small noncoding molecules might be therapeutic targets for the development of more effective and specific pharmacological therapy for VKH. In this review, we discuss the latest evidence regarding regulation and alteration of miRNA associated with VKH disease and its treatment.

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Section: Vogt–koyanagi–harada Diseasementioning

confidence: 99%

Section: Vogt–koyanagi–harada Diseasementioning

confidence: 99%

miRNA Landscape in Pathogenesis and Treatment of Vogt–Koyanagi–Harada Disease

Vega-Tapia

Bustamante

Valenzuela

et al. 2021

Front. Cell Dev. Biol.

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“…In ADJUVITE randomized trial, patients were given adalimumab and methotrexate for two months and it was found that ocular infl ammation was decreased in 56% patients and laser fl are photometry examination showed improvement in 30% patients with anterior uveitis. The results of these clinical trials showed that adalimumab is effective in treating ocular infl ammation and preventing relapses [34,35].…”

Section: Tnf-α Inhibitorsmentioning

confidence: 99%

“…A recent study has specifi ed that both golimumab and certolizumab can be effective and safe options for patients with uveitis even if the result with other TNF- inhibitors have not been effi cacious [41]. Canakinumab, an Anti-IL-1; Anakinra, an IL-1 receptor antagonist; and Rituximab, an Anti CD20 antibody [35].…”

Section: Tnf- Is the Cytokine That Gets Binds To The Tumour Necrosismentioning

confidence: 99%

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Recent Potential Treatment Approaches for the Management of Uveitis

Nikita¹,

Sultana²

2020

J Clin Res Ophthalmol

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Uveitis is an infl ammatory disease affecting the uveal tract of the eye. Non-infectious uveitis [NIU] is known to be the main cause of blindness in people of all age groups in different parts of the world. NIU can be both due to autoimmune or idiopathic responses causing severe vision-related complications leading to irreversible vision loss. Thus, the treatment of this disease after the rapid diagnosis and evaluation by eminent ophthalmologists and rheumatologists is very important. The primary goal of treatment of uveitis is to limit the infl ammation process and prevent recurring responses and hence preserving the vision. The current treatment therapies include corticosteroids as fi rst-line agents followed by more potent drugs including synthetic immunosuppressants like calcineurin inhibitors, antimetabolites, and alkylating agents. However, some patients are reported to be intolerant to these therapies, therefore, biologic agents are adopted as an effective treatment approach in such cases. Anti TNF-α agents have shown promising results in the treatment process. This review enlightens about the current effective treatment approaches that are adopted as potential therapeutic agents preventing NIU.

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Pathogenesis and current therapies for non-infectious uveitis

Tao

Zhu

et al. 2022

Clin Exp Med

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Non-infectious uveitis (NIU) is a disorder with various etiologies and is characterized by eye inflammation, mainly affecting people of working age. An accurate diagnosis of NIU is crucial for appropriate therapy. The aim of therapy is to improve vision, relieve ocular inflammation, prevent relapse, and avoid treatment side effects. At present, corticosteroids are the mainstay of topical or systemic therapy. However, repeated injections are required for the treatment of chronic NIU. Recently, new drug delivery systems that may ensure intraocular delivery of therapeutic drug levels have been highlighted. Furthermore, with the development of immunosuppressants and biologics, specific therapies can be selected based on the needs of each patient. Immunosuppressants used in the treatment of NIU include calcineurin inhibitors and antimetabolites. However, systemic immunosuppressive therapy itself is associated with adverse effects due to the inhibition of immune function. In patients with refractory NIU or those who cannot tolerate corticosteroids and immunosuppressors, biologics have emerged as alternative treatments. Thus, to improve the prognosis of patients with NIU, NIU should be managed with different drugs according to the response to treatment and possible side effects.

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New Pharmacological Strategies for the Treatment of Non-Infectious Uveitis. A Minireview

Cited by 22 publications

References 85 publications

miRNA Landscape in Pathogenesis and Treatment of Vogt–Koyanagi–Harada Disease

miRNA Landscape in Pathogenesis and Treatment of Vogt–Koyanagi–Harada Disease

Recent Potential Treatment Approaches for the Management of Uveitis

Pathogenesis and current therapies for non-infectious uveitis

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