Technology allows detection of target molecules and production of biologic agents for treatment of ocular inflammatory disorders.

Abstract

Although the precise pathogenic mechanisms of uveitis remain unknown, cytokines, chemokines and soluble adhesion molecules appear to play a major role in uveitis. They influence the communications between various cell types and alter vascular endothelial properties. Several recent studies have disclosed the beneficial role of aqueous humor samples for investigating involved molecular targets in various diseases leading to uveitis and potentially for specific treatments. Anterior chamber paracentesis for obtaining aqueous humor allows measurement of therapeutic targets and enables investigators to produce specific antagonists. Three classes of immunosuppressive drugs have been most frequently used for treatment of uveitis; these include antimetabolites, T‑cell inhibitors and alkylating agents all of which are slow acting and cause treatment efficacy in up to 76% of cases. [1,2] There are other drawbacks to these class of agents: In autoimmune disease, immunosuppressive therapies affecting one organ or site may not necessarily be effective on another organ/site, even when the inflammation is the manifestation of the same disease in the same individual. Furthermore, treatment with immunosuppressive agents may be complicated by serious side effects. A new development in uveitis treatment during the recent years is the development of biologic agents. Refractory cases of uveitis with or without retinal vasculitis may benefit from biologic agents of which, interferon‑alpha (INF‑α), interleukin (IL) 1 blocking agents, and tumor necrosis factor (TNF) blockers have been used successfully in some case reports. There is strong evidence that aqueous humor levels of many cytokines such as IL‑6, IL‑10, IL‑15, IL‑17, IL‑23, IL‑27, IL‑35, TNF‑α, transforming growth factor beta (TGF‑β), interferon‑γ and vascular endothelial growth factor (VEGF) in noninfectious autoimmune uveitis are elevated and the earlier mentioned and upcoming new biologic agents will be increasingly used