Understanding uveitis: The impact of research on visual outcomes
Understanding uveitis: The impact of research on visual outcomes
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DOI：
10.1016/j.preteyeres.2011.06.005
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发表时间：
2011-11-01
影响因子：
17.8
通讯作者：
Lightman, Sue
中科院分区：
文献类型：
--
作者：
de Smet, Marc D.;Taylor, Simon R. J.;Lightman, Sue
葡萄膜炎一词涵盖了一组非常不同的炎症性眼病，这些疾病造成了严重的法律和经济失明负担。事实上，葡萄膜炎的社会经济影响至少与糖尿病视网膜病变一样显著，而且在大多数情况下，受影响的是处于工作年龄的年轻人。通过使用动物模型，我们对炎症过程背后的机制的理解已经取得了重大进展，但事实证明与人类疾病的相关性难以捉摸，许多在动物模型中似乎非常有效的科学方法在患者中被证明不那么有效。然而，由于目前的治疗是基于皮质类固醇和免疫抑制药物，其有效性受到许多副作用的限制，因此需要有效的、有针对性的治疗。本文的目的是总结葡萄膜炎的临床研究现状，找出我们知识中的差距，并为未来葡萄膜炎研究的各个方面的发展提出新的机会和方法，包括流行病学、经济影响分析、诊断、治疗和临床研究设计。最佳的患者管理和有效的药物开发依赖于经过验证的结构化工具，例如那些帮助推动可用于评估和治疗类风湿性关节炎和癌症患者的手段和方法的快速加速。随着讨论的问题得到解决，葡萄膜炎护理应该会出现类似的繁荣。(C)2011爱思唯尔有限公司。保留所有权利。
The term uveitis encompasses a very diverse group of inflammatory ocular diseases that cause a significant burden of legal and economic blindness. Indeed, the socioeconomic impact of uveitis is at least as significant as that of diabetic retinopathy and, in the majority of cases, those affected are young individuals of working age.Significant progress has been made in our understanding of the mechanisms underlying the inflammatory process through the use of animal models, but correlation with human disease has proved elusive and many scientific approaches which appear highly effective in animal models prove to be less effective in patients. Nevertheless, effective, targeted treatments are needed in uveitis as current treatment is based on corticosteroids and immunosuppressive drugs whose usefulness is limited by their many side-effects.The aims of this review are to summarize the state of clinical research in uveitis, to identify gaps in our knowledge, and to propose new opportunities and methodologies for future developments in all aspects of uveitis research, including epidemiology, economic impact analysis, diagnosis, therapeutics, and clinical study design. Optimal patient management and efficient drug development depend on validated structured tools, such as those that have helped to drive a rapid acceleration in the means and methods available to assess and treat patients with rheumatoid arthritis and cancer. Uveitis care should witness a similar boom as the issues discussed are resolved. (C) 2011 Elsevier Ltd. All rights reserved.