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T Cell Inhibitors

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Treatment of Non-infectious Uveitis

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Abstract

T cells are intimately involved in noninfectious autoimmune uveitis, and their inhibition has been shown in both experimental models and human disease to be beneficial in controlling ocular inflammation. Two categories of T cell inhibitors exist, the calcineurin inhibitors, consisting of cyclosporine and tacrolimus, and the mammalian target of rapamycin (mTOR) inhibitors, consisting of sirolimus (also known as rapamycin) and everolimus. All are available as oral formulations, and, in addition, sirolimus is under study as a locally administered agent. All four compounds are metabolized by the cytochrome P450 enzyme system and therefore have the potential for significant drug-drug interactions. In addition, sometimes serious side effects can develop, including systemic hypertension and nephrotoxicity that require tight monitoring. Despite these limitations, the T cell inhibitors provide a useful addition to the uveitis treatment armamentarium.

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  1. Uveitis and Ocular Inflammatory Diseases Service, Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA

    Russell W. Read

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  1. Oregon Health and Science University, Casey Eye Institute, Portland, OR, USA

    Phoebe Lin

  2. Oregon Health and Science University, OHSU-PSU School of Public Health, Portland Veterans Administration Medical Center, Portland, OR, USA

    Eric Suhler

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Read, R.W. (2019). T Cell Inhibitors. In: Lin, P., Suhler, E. (eds) Treatment of Non-infectious Uveitis. Springer, Cham. https://doi.org/10.1007/978-3-030-22827-9_5

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