Endogenous cytokine

Evaluation of Birdshot Retinochoroidopathy Treatment by Either Steroid or Interferon alpha2a (Birdferon) Christine FARDEAU. France. 2008.  This gives details of the thinking behind offering Birdshot patients treatment with Interferon a. It has worked in Behcet’s patients and the study organisers are concerned about the side effects of immunosuppressants in general and cyclosporine in particular.

It gives links to the side effects profiles of Interferon, cyclosporine and cortisteroid. There is also a link to a German study of the use of Interferons  a and b for Behcet’s patients. In the German study at University Hospital, Department of Internal Medicine II, Tübingen, by Kotter, Gunavdin, Zierhut and Stubiger, 338 patients received either Interferon a or Interferon b. There was a 56% long term remission rate after Interferon was discontinued with Interferon a considered more effective than Interferon b and a higher dose regimen  more effective than a lower dose one

Monoclonal antibody

Monoclonal antibody therapy is the use of monoclonal antibodies (or mAb) to specifically bind to target cells or proteins. This may then stimulate the patient’s immune system to attack those cells.

Daclizumab for Treatment of Birdshot Chorioretinopathy. Sobrin Lucia  ; Huang John J.  ; Christen William ; Kafkala Chrysanthi  ; Choopong Pitipol  ; Foster C. Stephen. US. 2008.

Eight Birdshot patients who failed traditional IMT, or were intolerant of it, received  daclizumab (zenapax) intravenously at two week intervals initially. After just over two years of follow up, seven patients had either stabilization or improvement in visual acuity of both eyes, four were able to discontinue all other IMT and remain inflammation free while receiving only daclizumab (zenapax), but ERG results (measures retinal function) continued to decline in some.

Daclizumab has since been withdrawn from the market, not on account of side affects but on grounds of cost.