The Complete Success in Refractory Mooren's Ulcer Treated with Infliximab
Ayşe İdil Çakmak1, Yonca Akova2, Nilgün Yıldırım3
1Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sokmen Medical School, Hatay, Turkey.
Ocular Immunology and Inflammation
|July 13, 2022
Summary
Infliximab effectively treated two rare cases of Mooren's ulcer, a painful autoimmune corneal disease, that resisted standard treatments. This offers a new therapeutic option for severe ocular inflammation.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Mooren's ulcer is a rare, painful, peripheral ulcerative corneal disease with autoimmune associations.
- Management of ocular inflammation in Mooren's ulcer can be challenging, especially in refractory cases.
Observation:
- Two patients with progressive bilateral Mooren's ulcer, refractory to conventional immunosuppressive therapy, were treated.
- Treatment involved infliximab, an anti-tumor necrosis factor alpha agent.
Findings:
- Infliximab treatment led to significant improvement in disease progression for both patients.
- No corneal thinning or perforation was observed during follow-up after infliximab therapy.
Implications:
- Infliximab demonstrates potential efficacy as a treatment for Mooren's ulcer resistant to standard immunosuppressive therapies.
- This finding may guide future management strategies for severe, refractory cases of this ulcerative corneal disease.
Keywords:
Anti-tumor necrosis factor alphaMooren’s ulcerimmunosuppresioninfliximabperipheral ulcerative keratititsMore Related Videos
Related Concept Videos
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
260
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
260
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
226
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
226
01:29Drugs for Treatment of Ulcerative Colitis in IBD
230
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
230
01:24Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
672
In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
672
01:29Inflammatory Bowel Disease IV: Pharmacological Management
176
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
176
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
197
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
197