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Primed Mycobacterial Uveitis PMU as a Model for Post-Infectious Uveitis
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Recent Developments in HLA B27 Anterior Uveitis.

Denis Wakefield1,2, Daniel Clarke3, Peter McCluskey4,5

  • 1Faculty of Medicine, University of NSW Sydney, Kensington, NSW, Australia.

Frontiers in Immunology
|January 20, 2021
PubMed
Summary
This summary is machine-generated.

Acute anterior uveitis (AAU) is a polygenic condition linked to spondyloarthropathies. Recent research highlights the microbiome

Keywords:
HLA B27acute anterior uveitismicrobiomepathogenesisreview

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Area of Science:

  • Ophthalmology
  • Immunology
  • Genetics

Background:

  • Acute anterior uveitis (AU) is a complex eye condition with established links to systemic inflammatory diseases.
  • Genetic studies reveal AU as a polygenic disease, sharing associations with seronegative arthropathies and inflammatory bowel diseases.
  • Emerging research explores the influence of the microbiome and human leukocyte antigen B27 (HLA B27) in AU pathogenesis.

Purpose of the Study:

  • To summarize recent advancements in understanding the pathogenesis, clinical presentation, and treatment of acute anterior uveitis (AAU).
  • To review the genetic underpinnings and associated systemic conditions of AAU.
  • To highlight novel therapeutic strategies, including anti-cytokine therapies, for severe and recurrent AAU cases.

Main Methods:

  • Review of large gene-wide association studies and clinical investigations.
  • Analysis of research on the role of the microbiome and HLA B27 in AU.
  • Evaluation of treatment outcomes for topical, regional, and systemic immunosuppressive therapies, including anti-cytokine treatments.

Main Results:

  • Genetic studies confirm AU as a polygenic disease with significant overlap with spondyloarthropathies and inflammatory bowel diseases.
  • Clinical studies consistently identify typical AAU features and treatment responses.
  • Anti-cytokine therapies targeting tumor necrosis factor (anti-TNF) and interleukin 6 (IL-6) show efficacy in severe, recurrent, and JIA-associated AAU.

Conclusions:

  • Significant progress has been made in understanding AAU's genetic basis and clinical management.
  • Therapeutic strategies have advanced, with anti-cytokine therapies offering new options for complex cases.
  • Further research into the microbiome's role may offer future treatment avenues for AAU.