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DOI: 10.1055/s-2001-15886
Georg Thieme Verlag Stuttgart ·New York
Anti-inflammatoires non stéroïdiens (AINS) et inflammation oculaire
Nonsteroidal antiinflammatory drugs (NSAID) and ocular inflammation - a reviewPublication History
Publication Date:
31 December 2001 (online)
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Nichtsteroidale Entzündungshemmer und Augenentzündungen - eine Übersicht
Hintergrund Die okuläre Entzündung wird von komplexen Vorgängen bestimmt, welche unter anderem für die Aufhebung der Blut-Augen-Schranke und die Chemotaxis von Entzündungszellen zum Auge verantwortlich sind.
Material und Methoden Zusammenfassung der Eigenschaften und Nebenwirkungen der NSAID gemäß Literatur.
Ergebnisse Entzündungsmediatoren, insbesondere Prostaglandine und Zytokine, sind die wesentlichen steuernden Faktoren. Obwohl die hemmende Wirkung des Aspirins und der nichtsteroidalen Entzündungshemmer (NSAID) seit 1971 bekannt ist, wurden doch die beiden Isoenzyme der Zyklooxygenase erst kürzlich beschrieben. Die konstitutive Form des Cox-1 ist für die Produktion des PGE2 verantwortlich, welches in der gastrointestinalen Zytoprotektion, der Plättchen-Aggregation und dem Erhalt der Nierenfunktion mitspielt. Die Produktion des Isoenzymes Cox-2 wird durch eine Entzündung ausgelöst. Die Anwesenheit von COX-2 konnte in gewissen Augengeweben nachgewiesen werden (Hornhautepithel und RP-Epithel usw. …). Klinisch werden NSAID erfolgreich eingesetzt, um Entzündungen und deren Schmerzen zu kontrollieren, perioperativ eine Mydriase zu unterhalten und postoperativ dem zystoiden Makulaödem vorzubeugen.
Schlussfolgerungen Die NSAID sind wirkungsvolle Entzündungshemmer. Vorsicht ist jedoch angebracht bei trockenen Augen oder bei Allergiebereitschaft.
Background Ocular inflammation is regulated by complicated mechanism that are responsible for the rupture of the blood-ocular barrier and the attraction of leukocytes towards the eye. This cellular trafficking is regulated by the liberation of inflammatory mediators and cytokines.
Materials and methods The main effects of prostaglandins that are described in the literature were rewied.
Results Despite the fact that the inhibitory action of aspirin and NSAIDs on prostaglandins secretion is known since 1971, it is quite recently that two isoenzymes of cyclooxygenase were discovered. The Cyclooxygenase-1 (COX-1) is constitutive and is responsible for the production of PGE2. This prostaglandin is related to the housekeeping functions such as gastric protection, platelet aggregation and maintenance of renal function. The expression of the cyclooxygenase 2 (COX-2) is induced by inflammation. The presence of COX-2 could be demonstrated in many ocular tissues (corneal epithelium and endothelium, pigmentary epithelium etc. …) The use of NSAIDs in clinical practice allows a good control of ocular inflammation, of pain, of the maintenance of a good mydriasis during surgery and are impending the onset of postoperative cystoid macular edema.
Conclusion Prostaglandins are potent anti-inflammatory agents but their use is limited in the presence of severe dry eye syndrome or allergy towards NSAIDs.
Schlüsselwörter
Nichtsteroidale Entzündungshemmer - Prostaglandine - Diclofenac Na - Flurbiprofen - Ketorolac
Key words
NSAIDs - prostaglandin - diclofenac Na - flurbiprofen - ketorolac
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