Mease P J
Seattle Rheumatology Associates and Division of Clinical Research, Swedish Hospital Medical Centre, and University of Washington, 98104, USA.
Ann Rheum Dis. 2001 Nov;60 Suppl 3(Suppl 3):iii37-40. doi: 10.1136/ard.60.90003.iii37.
The cellular events underlying the pathogenesis of psoriatic arthritis (PsA) and psoriasis have not yet been fully elucidated. Nevertheless, some clues to these conditions are beginning to emerge. In particular, a growing body of data supports the role of proinflammatory cytokines, such as tumour necrosis factor (TNF), in the pathophysiology of PsA and psoriasis. Raised levels of these cytokines are found in the joints of patients with PsA, as well as in psoriatic skin lesions. Physiotherapy, non-steroidal anti-inflammatory agents, corticosteroids, and disease modifying antirheumatic agents, such as methotrexate, are the most commonly used treatments for PsA. However, the data supporting the effectiveness of these treatments are limited, and disease resolution is usually incomplete. This study examined the effects of etanercept, a TNF inhibitor, in patients with PsA. Etanercept treatment was well tolerated and resulted in significant improvement in the signs and symptoms of PsA and in psoriatic skin lesions. Infliximab, another TNF inhibitor, has also been shown to be effective in patients with PsA. Such studies confirm the importance of proinflammatory cytokines in PsA, and hold out hope for patients who require new options for the treatment of their disease.
银屑病关节炎(PsA)和银屑病发病机制背后的细胞事件尚未完全阐明。然而,有关这些病症的一些线索已开始显现。特别是,越来越多的数据支持促炎细胞因子,如肿瘤坏死因子(TNF),在PsA和银屑病病理生理学中的作用。在PsA患者的关节以及银屑病皮肤病变中都发现了这些细胞因子水平升高。物理治疗、非甾体抗炎药、皮质类固醇以及改善病情的抗风湿药,如甲氨蝶呤,是PsA最常用的治疗方法。然而,支持这些治疗有效性的数据有限,疾病缓解通常不完全。本研究考察了TNF抑制剂依那西普对PsA患者的影响。依那西普治疗耐受性良好,并使PsA的体征和症状以及银屑病皮肤病变有显著改善。另一种TNF抑制剂英夫利昔单抗也已被证明对PsA患者有效。此类研究证实了促炎细胞因子在PsA中的重要性,并为需要新治疗选择的患者带来了希望。
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