Vogt-Koyanagi-Harada Syndrome: Clinical Features, Immunogenetic Predisposition and PD-1 Inhibitor-Induced Forms-A...

Area of Science:

• Ophthalmology
• Immunology
• Genetics

Background:

• Vogt-Koyanagi-Harada syndrome (VKH) is a rare autoimmune disorder targeting melanocytes, potentially causing uveitis and vision loss.
• Immune checkpoint inhibitors (ICIs), particularly PD-1 inhibitors, are crucial in oncology but can induce immune-related adverse events, including VKH-like uveitis.

Purpose of the Study:

• To review VKH syndrome's clinical aspects, diagnosis, and treatment.
• To explore immunopathological mechanisms of drug-induced VKH, especially related to PD-1 inhibitors.
• To analyze genetic, epigenetic, and environmental risk factors for VKH.

Main Methods:

• Literature review of VKH syndrome and ICI-induced uveitis.
• Analysis of immunopathological mechanisms.
• Examination of genetic and environmental predisposing factors.

Main Results:

• VKH affects eyes, inner ear, meninges, and skin due to immune response against melanocytes.
• Delayed diagnosis and treatment of VKH can lead to chronic uveitis and visual impairment.
• ICI therapy, particularly PD-1 inhibitors, can trigger VKH-like uveitis, necessitating careful monitoring.

Conclusions:

• Understanding VKH pathogenesis, including drug-induced forms, is vital for timely diagnosis and management.
• Identifying at-risk individuals for drug-induced VKH is crucial for patient safety.
• Further research into genetic and environmental factors may improve VKH prevention and treatment strategies.