Novel Approaches to the Treatment of Noninfectious Uveitis

Patients with vision-threatening noninfectious autoimmune or autoinflammatory uveitis are frequently treated with immunosuppression [1]. Some of these individuals will respond to treatment with conventional immunosuppressive drugs (e.g., antimetabolites covered in Chap. 4 or alkylating agents covered in Chap. 6), tumor necrosis factor (TNF) blockers (Chap. 7), or the interferons (Chap. 10). For a substantial number of patients, however, these drugs will not be effective and/or there will be contraindications or side effects that limit use. Thus, there is considerable interest in the development of alternative therapeutic
agents for these patients, targeted to pathogenic mechanisms of the disease [2]. There are multiple potential groups of biological drug targets. This chapter contains a discussion of selected promising targets that are on the horizon for treatment of severe noninfectious uveitis, either in clinical trials or in preclinical testing: leukocytes, adhesion molecules, inflammatory cytokines, the complement system, and oxidative stress.