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Local therapies for inflammatory eye disease in translation: past, present and future

Tempest-Roe, S, Joshi, L, Dick, AD and Taylor, SRJ (2013) Local therapies for inflammatory eye disease in translation: past, present and future BMC OPHTHALMOLOGY, 13 (UNSP 3).

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Abstract

Despite their side-effects and the advent of systemic immunosuppressives and biologics, the use of corticosteroids remains in the management of patients with uveitis, particularly when inflammation is associated with systemic disease or when bilateral ocular disease is present. The use of topical corticosteroids as local therapy for anterior uveitis is well-established, but periocular injections of corticosteroid can also be used to control mild or moderate intraocular inflammation. More recently, intraocular corticosteroids such as triamcinolone and steroid-loaded vitreal inserts and implants have been found to be effective, including in refractory cases. Additional benefits are noted when ocular inflammation is unilateral or asymmetric, when local therapy may preclude the need to increase the systemic medication.Implants in particular have gained prominence with evidence of efficacy including both dexamethasone and fluocinolone loaded devices. However, an appealing avenue of research lies in the development of non-corticosteroid drugs in order to avoid the side-effects that limit the appeal of injected corticosteroids. Several existing drugs are being assessed, including anti-VEGF compounds such as ranibizumab and bevacizumab, anti-tumour necrosis factor alpha antibodies such as infliximab, as well as older cytotoxic medications such as methotrexate and cyclosporine, with varying degrees of success. Intravitreal sirolimus is currently undergoing phase 3 trials in uveitis and other inflammatory pathways have also been proposed as suitable therapeutic targets. Furthermore, the advent of biotechnology is seeing advances in generation of new therapeutic molecules such as high affinity binding peptides or modified high affinity or bivalent single chain Fab fragments, offering higher specificity and possibility of topical delivery

Item Type: Article
Subjects : Clinical Medicine
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine > Department of Clinical and Experimental Medicine
Authors :
AuthorsEmailORCID
Tempest-Roe, SUNSPECIFIEDUNSPECIFIED
Joshi, LUNSPECIFIEDUNSPECIFIED
Dick, ADUNSPECIFIEDUNSPECIFIED
Taylor, SRJUNSPECIFIEDUNSPECIFIED
Date : 6 August 2013
Identification Number : 10.1186/1471-2415-13-39
Uncontrolled Keywords : Science & Technology, Life Sciences & Biomedicine, Ophthalmology, OPHTHALMOLOGY, CYSTOID MACULAR EDEMA, INTRAVITREAL TRIAMCINOLONE ACETONIDE, ENDOTHELIAL GROWTH-FACTOR, OPHTHALMIC WEGENERS-GRANULOMATOSIS, POSTERIOR SUBTENON INJECTION, RANDOMIZED CLINICAL-TRIAL, NERVOUS-SYSTEM LYMPHOMA, ACUTE ANTERIOR UVEITIS, FLUOCINOLONE ACETONIDE, NONINFECTIOUS UVEITIS
Related URLs :
Additional Information : © 2013 Tempest-Roe et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Depositing User : Symplectic Elements
Date Deposited : 11 Mar 2016 13:52
Last Modified : 11 Mar 2016 13:52
URI: http://epubs.surrey.ac.uk/id/eprint/810099

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