Document Detail


Use of systemic T-lymphocyte signal transduction inhibitors in the treatment of atopic keratoconjunctivitis.
MedLine Citation:
PMID:  18724148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Topical immunomodulators such as tacrolimus have revolutionized the treatment of atopic dermatitis. Because T lymphocytes are integral to the pathogenesis of atopic dermatitis, systemic treatment with T-lymphocyte signal transduction inhibitors should ameliorate both the dermatologic and ocular manifestations. We describe the successful treatment of 6 patients with severe atopic keratoconjunctivitis (AKC) resistant to conventional therapies. METHODS: Retrospective observational case series. The charts of patients with AKC assessed by 1 of the authors were reviewed to identify those treated with systemic T-cell signal transduction inhibitors. Visual acuities, previous treatments, and the response to systemic signal transduction inhibitors were observed and reported in 6 patients. RESULTS: The patients had a mean duration of AKC of 21 years. Topical corticosteroids and antihistamines had failed to control signs and symptoms of the disease in all patients, and in some patients, systemic corticosteroids and topical cyclosporine were ineffective. Three patients were treated with systemic cyclosporine, and 3 were treated with systemic tacrolimus. One patient was subsequently treated with daclizumab in addition to tacrolimus. All 6 patients experienced complete remission of their AKC and an increase in visual acuity. CONCLUSIONS: Selective systemic immunosuppression of T lymphocytes with cyclosporine or tacrolimus has proved effective in the treatment of both atopic dermatitis and atopic keratoconjunctivitis. We advocate the consideration of systemic therapy in cases that are resistant to conventional treatment to resolve inflammation and preserve vision. Further studies in this area are advocated.
Authors:
Fahd Anzaar; Micheal Joseph Gallagher; Pooja Bhat; Mansoor Arif; Saadia Farooqui; C Stephen Foster
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cornea     Volume:  27     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-25     Completed Date:  2008-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  884-8     Citation Subset:  IM    
Affiliation:
Massachusetts Eye Research and Surgery Institute, Cambridge, MA 02142, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / therapeutic use
Conjunctivitis, Allergic / drug therapy*
Cyclosporine / therapeutic use
Drug Therapy, Combination
Female
Humans
Immunoglobulin G / therapeutic use
Immunosuppressive Agents / therapeutic use*
Infusions, Intravenous
Male
Middle Aged
Retrospective Studies
Signal Transduction / drug effects*
T-Lymphocytes / drug effects*
Tacrolimus / therapeutic use
Visual Acuity
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin G; 0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 152923-56-3/daclizumab; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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