Cyclosporine vs tacrolimus therapy for posterior and intermediate uveitis
Cyclosporine vs tacrolimus therapy for posterior and intermediate uveitis
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DOI：
10.1001/archopht.123.5.634
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发表时间：
2005-05-01
影响因子：
--
通讯作者：
Dick, AD
中科院分区：
文献类型：
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作者：
Murphy, CC;Greiner, K;Dick, AD
目的：比较他克莫司和环孢霉素治疗非感染性眼后段炎症的疗效和耐受性，并评估其对外周血CD 4（+）T细胞表型和活化状态的影响。方法：37例需要二线免疫抑制治疗眼后段炎症的患者参加了他克莫司与环孢霉素治疗的前瞻性随机试验。主要观察指标为视力、双眼间接检眼镜检查评分、不良反应和生活质量。此外，在治疗前和治疗后2、4和12周，使用CD 69、趋化因子受体（CD 4 R）和CD 4 T细胞（CD 4 + T细胞）通过流式细胞术评估外周血CD 4 + T细胞表型和活化状态。（CCR 4、CCR 5和CXCR 3）和细胞内细胞因子（肿瘤坏死因子α、干扰素-γ和白细胞介素10）表达。13名服用他克莫司的患者（68%）和12名服用环孢素的患者（67%）对治疗有反应。环孢素治疗与报告的不良反应发生率较高相关。3个月时，环孢素组的平均动脉压和血清胆固醇水平显著高于他克莫司组。对于生活质量或CD 4（+）T细胞表型的影响没有显著差异。结论：他克莫司和环孢素对眼后段炎症的疗效相似，但结果表明他克莫司治疗更安全。
Objectives: To compare the efficacy and tolerability of tacrolimus and cyclosporine therapy for noninfectious posterior segment intrancular inflammation and to evaluate their effect on peripheral blood CD4(+) T-cell phenotype and activation status.Methods: Thirty-seven patients who required second-line immunosuppression for posterior segment intraocular inflammation were enrolled in this prospective randomized trial of tacrolimus vs cyclosporine therapy. The main outcome measures were visual acuity, binocular indirect ophthalmoscopy score, adverse effects, and quality of life. In addition, peripheral blood CD4(+) T-cell phenotype and activation status were evaluated by now cytometry before treatment and at 2, 4, and 12 weeks using CD69, chemokine receptor (CCR4, CCR5, and CXCR3), and intracellular cytokine (tumor necrosis factor alpha, interferon-gamma, and interleukin 10) expression.Results: Thirteen patients (68%) taking tacrolimus and 12 patients (67%) taking cyclosporine responded to treatment. Cyclosporine therapy was associated with a higher incidence of reported adverse effects. Mean arterial pressure and serum cholesterol level were significantly higher at 3 months in the cyclosporine group than the tacrolimus group. No significant difference was detected with regard to effect on quality of life or CD4(+) T-cell phenotype.Conclusions: Tacrolimus and cyclosporine were similar with regard to efficacy for posterior segment intraocular inflammation, but the results suggested a more favorable safety profile for tacrolimus therapy.