[类风湿关节炎中的基因转移免疫疗法：前景]
[Gene transfer immunotherapy in rheumatoid arthritis: perspectives].
作者信息
Jorgensen C
机构信息
Service d'immunorhumatologie, hôpital Lapeyronie, 34295 Montpellier, France.
出版信息
Rev Med Interne. 2001 Feb;22(2):163-71. doi: 10.1016/s0248-8663(00)00306-4.
INTRODUCTION
Tumor necrosis factor (TNF) blocking agents have changed the therapeutic approach in rheumatoid arthritis, but a true clinical remission remains rare. Gene therapy opens new perspectives in immunotherapy in rheumatoid arthritis. This review focuses on the research, data and clinical development in rheumatoid arthritis using this strategy.
CURRENT KNOWLEDGE AND KEY POINTS
New therapeutical targets have been described besides the cytokine inhibitors: apoptosis inducers, angiogenesis inhibitors and metalloprotease inhibitors, cell activation and signalization have been used in experimental models to inhibit arthritis. Gene therapy makes it possible to better understand the physiopathology of rheumatoid arthritis and offers the opportunity to induce true remissions of experimental arthritis.
FUTURE PROSPECTS AND PROJECTS
Biotechnology allows the development of new safer vectors which permit long-term expression. However, the difficulties to produce high titers and safe vectors limit the use of this strategy. The previous clinical data on gene therapy in rheumatoid arthritis are limited to feasibility studies. We believe that the efficiency of gene therapy will be obtained by combining two or more complementary targets.
引言
肿瘤坏死因子（TNF）阻断剂改变了类风湿关节炎的治疗方法，但真正的临床缓解仍然很少见。基因治疗为类风湿关节炎的免疫治疗开辟了新的前景。本综述重点关注使用该策略在类风湿关节炎方面的研究、数据和临床进展。
当前知识与要点
除了细胞因子抑制剂外，还描述了新的治疗靶点：凋亡诱导剂、血管生成抑制剂和金属蛋白酶抑制剂，细胞活化和信号传导已在实验模型中用于抑制关节炎。基因治疗使人们能够更好地理解类风湿关节炎的病理生理学，并为诱导实验性关节炎的真正缓解提供了机会。
未来前景与项目
生物技术有助于开发新的更安全的载体，可实现长期表达。然而，生产高滴度和安全载体的困难限制了该策略的应用。先前关于类风湿关节炎基因治疗的临床数据仅限于可行性研究。我们认为，通过结合两个或更多互补靶点将获得基因治疗的疗效。
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