Corticosteroids and Anti-Complement Therapy in Retinal Diseases.
Corticosteroids are unique in that they are the one class of agents that acts upon most of the multiple processes in the pathophysiology of macular edema. Corticosteroids are capable of inhibiting prostaglandin and leukotriene synthesis as well as interfering with intercellular adhesion molecule-1 (ICAM-1), interleukin-6, VEGF-A, and stromal cell derived factor-1 pathways. Triamcinolone, dexamethasone, and fluocinolone have been extensively used in the treatment of retinal and choroidal vascular diseases. Sustained release implants of steroids have reduced the burden of repeated intravitreal injections necessary in most of the retinal diseases. Complement factors play an important role in the pathogenesis of age-related macular degeneration (AMD). Inhibitors of complement could provide a breakthrough in the treatment of dry AMD. Complement factor inhibitors, such as POT-4, lampalizumab, and eculizumab, have been tested in clinical trials for dry AMD with promising results. However, results of phase 3 trials are awaited.
Smt Kanuri Santhamma Vitreoretina Center, L.V. Prasad Eye Institute, Hyderabad, India.
Raja
R
Narayanan
UC Irvine Medical Center, Ophthalmology Clinic, Orange, CA, USA. bdkupper@uci.edu.
Baruch D
BD
Kuppermann
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D003165:Complement System Proteins; D003907:Dexamethasone / Q000627:therapeutic use; D005446:Fluocinolone Acetonide / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008269:Macular Edema / Q000188:drug therapy*; D014221:Triamcinolone / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D061067:Antibodies, Monoclonal, Humanized; D007140:Immunoglobulin Fab Fragments; D005446:Fluocinolone Acetonide; D014221:Triamcinolone; D003907:Dexamethasone; D003165:Complement System Proteins; C481642:eculizumab; C035394:fluocinolone; C000603963:lampalizumab
Complement; Dexamethasone; Eculizumab; Fluocinolone; Lampalizumab; Steroids; Triamcinolone