Ocular immunosuppressive microenvironment and novel drug delivery for control of uveitis

Abstract

Ocular immune privilege is a phenomenon described by Peter Medawar in relation to the indefinite survival of the placement of foreign tissue grafts into the eye. Several mechanisms have been described that contribute to ocular immune privilege, such as a blood-ocular barrier and lack of lymphatics in the eye, the production of immune-suppressing molecules inside the ocular microenvironment, and the induction of systemic regulatory immunity against antigens found in the eye. Because ocular immune privilege is not absolute, failure of it can result in uveitis. Uveitis is a group of inflammatory disorders that can lead to vision loss if not treated properly. The current uveitis treatments involve the use of immunosuppressive and anti-inflammatory medications. Researching mechanisms of ocular immune privilege and the development of novel treatments for uveitis is ongoing. This review discusses mechanisms of ocular immune privilege, followed by an overview of uveitis treatments and ongoing clinical trials.

Trial registration: ClinicalTrials.gov NCT05155592 NCT03828019 NCT04588818 NCT01280669.

Keywords: Autoimmune uveitis; Non-infectious uveitis; Ocular drug delivery; Ocular immune privilege; Ocular inflammation; Uveitis.