Corticosteroids and Anti-Complement Therapy in Retinal Diseases.
Corticosteroids are unique in that they are the one class of agents that acts upon most of the multiple processes in the pathophysiology of macular edema. Corticosteroids are capable of inhibiting prostaglandin and leukotriene synthesis as well as interfering with intercellular adhesion molecule-1 (ICAM-1), interleukin-6, VEGF-A, and stromal cell derived factor-1 pathways. Triamcinolone, dexamethasone, and fluocinolone have been extensively used in the treatment of retinal and choroidal vascular diseases. Sustained release implants of steroids have reduced the burden of repeated intravitreal injections necessary in most of the retinal diseases. Complement factors play an important role in the pathogenesis of age-related macular degeneration (AMD). Inhibitors of complement could provide a breakthrough in the treatment of dry AMD. Complement factor inhibitors, such as POT-4, lampalizumab, and eculizumab, have been tested in clinical trials for dry AMD with promising results. However, results of phase 3 trials are awaited.
['Narayanan|Raja|R|', 'Kuppermann|Baruch D|BD|']
D000305:Adrenal Cortex Hormones D061067:Antibodies, Monoclonal, Humanized D003165:Complement System Proteins D003907:Dexamethasone D005446:Fluocinolone Acetonide D006801:Humans D007140:Immunoglobulin Fab Fragments D008269:Macular Edema D014221:Triamcinolone
Triamcinolone Dexamethasone Fluocinolone Steroids Complement Lampalizumab Eculizumab