英夫利昔单抗治疗难治性结节病。
Infliximab for refractory sarcoidosis.
作者信息
Baughman R P, Lower E E
机构信息
Department of Internal Medicine, University of Cincinnati Medical Center, OH, USA.
出版信息
Sarcoidosis Vasc Diffuse Lung Dis. 2001 Mar;18(1):70-4.
BACKGROUND AND AIM OF WORK
Tumor necrosis factor-alpha (TNF-alpha) appears to be an important cytokine in the inflammation of sarcoidosis. Infliximab is a chimeric monoclonal antibody which specifically inhibits TNF-alpha. We investigated the efficacy of infliximab for the therapy of chronic, resistant sarcoidosis.
METHODS
Patients with persistent symptomatic sarcoidosis despite corticosteroids and immunosuppressive agents were selected for treatment with infliximab. Patients were treated initially and at 2, 4, and 12 weeks with 5 mg/kg of infliximab at each treatment. Index lesions, which had progressed despite corticosteroid therapy, were reevaluated at 16 weeks.
RESULTS
Three patients were treated. In two patients, the index lesion was lupus pernio, which significantly improved with infliximab. The third patient had restrictive lung disease. At week 16, there was a 26% improvement in the vital capacity from pretreatment values. All patients tolerated the treatments well.
CONCLUSIONS
Infliximab was associated with significant improvement in chronic sarcoidosis.
工作背景与目的
肿瘤坏死因子-α（TNF-α）似乎是结节病炎症中的一种重要细胞因子。英夫利昔单抗是一种特异性抑制TNF-α的嵌合单克隆抗体。我们研究了英夫利昔单抗治疗慢性难治性结节病的疗效。
方法
选择尽管使用了皮质类固醇和免疫抑制剂但仍有持续性症状性结节病的患者接受英夫利昔单抗治疗。患者在初始治疗时以及在第2、4和12周时，每次治疗均给予5mg/kg的英夫利昔单抗。对尽管接受了皮质类固醇治疗但仍进展的指标性病变在第16周时进行重新评估。
结果
治疗了3例患者。2例患者的指标性病变为冻疮样狼疮，使用英夫利昔单抗后有显著改善。第3例患者患有限制性肺病。在第16周时，肺活量较治疗前值提高了26%。所有患者对治疗耐受性良好。
结论
英夫利昔单抗与慢性结节病的显著改善相关。
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