HLA-B27 Anterior Uveitis: Immunology and Immunopathology

Wakefield, Denis; Yates, William B.; Amjadi, Shahriar; McCluskey, Peter

doi:10.3109/09273948.2016.1158283

Cited by 43 publications

(46 citation statements)

References 95 publications

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“…In terms of anatomy, anterior uveitis is the most common, accounting for 50–65% of cases seen in Australian tertiary referral centres, with HLA‐B27 associated uveitis comprising 18–32% of these cases …”

Section: Classification and Epidemiologymentioning

confidence: 99%

“…7 In terms of anatomy, anterior uveitis is the most common, accounting for 50-65% of cases seen in Australian tertiary referral centres, 8 with HLA-B27 associated uveitis comprising 18-32% of these cases. 9 Uveitis is the most frequent ocular manifestation of sarcoidosis, occurring in 30-60% of sarcoidosis patients and representing 2-15% of all uveitis patients referred to tertiary centres. 10 Relapsing-remitting panuveitis or posterior uveitis is the primary ocular involvement in Behcet disease (BD), occurring in 50-70% of patients.…”

Section: Classification and Epidemiologymentioning

confidence: 99%

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The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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The uveitides are a heterogenous group of ocular inflammatory disorders that account for the third highest cause of blindness worldwide, responsible for 5–10% of visual impairment globally. Up to 35% of patients with uveitis can suffer significant vision loss. To prevent irreversible structural damage and blindness, it is important that the diagnosis and commencement of appropriate therapy occurs promptly. Management includes topical and systemic corticosteroid therapy and conventional immunomodulatory agents, including methotrexate, azathioprine, mycophenolate mofetil and cyclosporin. Significant progress has been made in the past decade in our understanding of the immunopathological pathways that drive intraocular inflammation, allowing the development of targeted therapy with biologic agents. These include TNF‐α inhibitors, such as infliximab, adalimumab and etanercept; interleukin blockers, such as tocilizumab and daclizumab; and other targeted therapies, such as rituximab and abatacept. The efficacy of these agents has been studied in cases of severe uveitis that are refractory to conventional immunomodulatory agents and provide exciting results that have revolutionised uveitis management. Though the biologic era has provided a large armamentarium to treat uveitis, ongoing challenges and cases of recalcitrant uveitis remain, posing a challenge to internal medicine physicians. This comprehensive review aims to construct an updated summary on the existing evidence pertaining to the use of biologic agents in the treatment of uveitis. Methods include a systematic search for studies between 2000 and 2018 using PubMed, EMBASE, Ovid MEDLINE and Cochrane libraries.

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Section: Classification and Epidemiologymentioning

confidence: 99%

Section: Classification and Epidemiologymentioning

confidence: 99%

The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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“…Additionally vascular abnormalities and endothelial dysfunction are considered to play a role in the pathogenesis of AAU, IBD, and psoriasis [18–20]. …”

Section: Introductionmentioning

confidence: 99%

Extra-Articular Symptoms in Constellation with Selected Serum Cytokines and Disease Activity in Spondyloarthritis

Przepiera-Będzak

Fischer

Brzosko

2016

Mediators of Inflammation

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Objectives. In this study, we assessed the extra-articular symptoms in constellation with selected serum cytokines and disease activity in spondyloarthritis (SpA). Patients and Methods. We studied 287 SpA patients: 131 had AS, 110 had PsA, and 46 had SAPHO. We assessed extra-articular symptoms in all cases. In 191 SpA patients, we measured serum interleukin-6 (IL-6), interleukin-18 (IL-18), interleukin-23 (IL-23), endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). Results. Patients with acute anterior uveitis (AAU) had higher VAS (P = 0.0008), BADSDAI (P = 0.0001), ASDAS-ESR (P = 0.04), CRP (P = 0.006), IL-6 (P = 0.02), and IL-18 (P = 0.03) levels. Patients with inflammatory bowel disease (IBD) had higher VAS (P = 0.03), CRP (P = 0.0009), and IL-6 (P = 0.0003) levels. Patients with skin psoriasis had lower VAS (P = 0.001) and BASDAI (P = 0.00007) levels. Patients with psoriatic onycholysis had lower VAS (P = 0.006), BASDAI (P = 0.00001), and CRP (P = 0.02) and higher IL-23 (P = 0.04) levels. Patients with PPP had lower BASDAI (P = 0.04) and higher ET-1 (P = 0.001) levels. Conclusions. SpA patients with increased serum IL-18 and decreased serum ET-1 had an increased risk of extra-articular symptoms. In SpA patients, increased disease activity was associated with an increased risk of AAU and IBD and a decreased risk of skin psoriasis, psoriatic onycholysis, and PPP.

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“…15 Previous studies furthermore showed that gut bacteria, such as Yersinia Enterocolitica and Salmonella typhimurium, are involved in the pathogenesis of SpA. 5,16 Significantly decreased genera such as Roseburia and butyrate production have been observed in Behçet patients as compared with healthy controls. 17 Commensal bacteria are thought to be a potential trigger and a factor which can influence the development of disease in experimental autoimmune uveitis (EAU).…”

mentioning

confidence: 99%

“…1,2 Acute anterior uveitis is the most common uveitis entity, 3 which is often accompanied with other systemic diseases such as ankylosing spondylitis (AS) and spondyloarthropathies (SpA). 4,5 Previous studies have shown that undiagnosed SpA occurs in about 40% of patients with idiopathic AAU. 6 The human leucocyte antigen B27 (HLA-B27) has been shown to have a strong association with AAU.…”

mentioning

confidence: 99%