title: [Topical Fk506 in inflammatory corneal and conjunctival diseases. A pilot study].
abstract: BACKGROUND
  Topical corticosteroids are the only effective measure in serious inflammatory corneal and conjunctival diseases. Although results obtained with topical cyclosporin A are encuraging it is not effective in all patients. The mode of action of Fk506 is similar to that of cyclosporin A, i.e. it exerts an inhibitory effect on transcription of interleukin 2 in T lymphocytes. The immunosuppressive potential of Fk506, however, is much larger. Furthermore, it penetrates more easily into cornea and conjunctiva. To find out whether the theoretical advantages of topical Fk506 can be translated into clinical practice, a selected group of patients refractory to conventional therapy was treated in this pilot study.
  
  
  METHODS
  Fk506 0.06 % was administered initially three times daily in 15 patients with atopic blepharokeratoconjunctivitis, Mooren's ulcer, ocular pemphigoid, Thygeson's superficial punctate keratitis, nummular adenoviral keratitis, graft-versus-host reaction of the conjunctiva and steroid response glaucoma after penetrating keratoplasty.
  
  
  RESULTS
  Within a follow-up of 26 +/- 15 weeks improvement was recorded in 5/15 patients and stabilization in 5/15 patients. In two patients progression of the disease was noted (one patient with progression of ocular pemphigoid, another patient with suspected automutilation). Premature withdrawal the drug was judged to be necessary in two patients with ocular surface disorders and in one patient with non-compliance.
  
  
  CONCLUSIONS
  Topical Fk506 seems to be a promising new immunosuppressive drug for patients with atopic blepharokeratoconjunctivitis, Thygeson's superficial punctate keratitis and nummular adenoviral keratitis. Exact efficacy in these and other corneal and conjunctival inflammatory diseases has to be determined in randomised clinical studies. Before these studies may start the risk of side-effects must be reduced via an improvement of the drops.
authors: Augenklinik der Heinrich-Heine-Universität, Düsseldorf, Germany. thomas.reinhard@uni-duesseldorf.de
authors: Thomas
authors: T
authors: Reinhard
authors: Alexander
authors: A
authors: Reis
authors: Susanne
authors: S
authors: Mayweg
authors: Hermann
authors: H
authors: Oberhuber
authors: Georg
authors: G
authors: Mathis
authors: Rainer
authors: R
authors: Sundmacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003231:Conjunctivitis / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007376:Interleukin-2 / Q000037:antagonists & inhibitors; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010865:Pilot Projects; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D007376:Interleukin-2; D009883:Ophthalmic Solutions; D016559:Tacrolimus