[The clinico-immunological validation of a differentiated approach to the use of corticosteroids in treating S-dependent uveoretinitis].
A total of 630 patients with uveitis of different etiology aged 5 to 70 were examined. Signs of autoimmunization with retinal S-antigens (mol. weight 48 kD) associated with retinal involvement were detected in more than half of them. A moderate level of S-antigen in the tears was found to promote a favorable outcome of uveoretinitis. Deficit or a drastic increase of S-antigen titers in the tears, accumulation of S-antibodies and circulating S-antigen-antibody complexes in the serum, and blood leukocyte migration inhibition in response to S-antigen were observed in chronic and complicated cases. As many as 75% focal chorioretinitis and panuveitis cases, 50% of posterior and 37% of peripheral uveitis were referred to S-related forms. The authors validate a differentiated approach to the treatment of S-uveoretinitis. If S-antibodies are accumulated only in the tears, local corticosteroids are effective; if both local and total-systems reactions are boosted, the maximal effect may be achieved by local and systemic corticosteroids and cytostatics. In case of a deficiency of S-antibodies in the tears immunodepressive therapy was of no avail, and good results could be attained only by immunomodulating therapy: corticosteroids+hemoperfusion in adults and corticosteroids+thymus preparations and/or interferonogens in children.
Slepova
O S
OS
Katargina
L A
LA
Zaĭtseva
N S
NS
Krichevskaia
G I
GI
Ermakova
N A
NA
Tankovskiĭ
V E
VE
Kushnir
V N
VN
Kalamkarov
G R
GR
Shevchenko
T F
TF
Bykovskaia
G N
GN
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000917:Antibody Formation; D019393:Arrestin / Q000276:immunology*; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D008297:Male; D008875:Middle Aged; D012173:Retinitis / Q000188:drug therapy* / Q000276:immunology*; D012189:Retrospective Studies; D014605:Uveitis / Q000188:drug therapy* / Q000276:immunology*
D000305:Adrenal Cortex Hormones; D019393:Arrestin
Kliniko-immunologicheskoe obosnovanie differentsirovannogo podkhoda k primeneniiu kortikosteroidov pri lechenii S-zavisimykh uveoretinitov.