Ossandon A, Cassarà E A M, Priori R, Valesini G
Dipartimento di Terapia Medica, Cattedra di Reumatologia, Università degli Studi di Roma La Sapienza, Rome, Italy.
Clin Exp Rheumatol. 2002 Sep-Oct;20(5):709-18.
Thalidomide is an immunomodulatory agent; although its mechanisms of action are not fully understood, many authors have described its anti-inflammatory and immunosuppressive properties. More interestingly, thalidomide has shown the ability to suppress tumor necrosis factor alpha (TNF alpha) production and to modify the expression of TNF alpha induced adhesion molecules on endothelial cells and on human leukocytes. Thalidomide has been used in several diseases (i.e. dermatological, autoimmune, gastrointestinal). In this review we focus specifically on the use of this drug in disorders with rheumatological features such as lupus erythematosus, rheumatoid arthritis and Still's disease, ankylosing spondylitis, and Behçet's disease. Despite its well known side effects, first of all peripheral nerve involvement and teratogenesis, which can be avoided by following strict guidelines, thalidomide could represent an alternative drug in some rheumatological conditions, particularly in patients who show resistance, contraindication or toxicity with other conventional treatments.
沙利度胺是一种免疫调节剂；尽管其作用机制尚未完全明确，但许多作者已描述了其抗炎和免疫抑制特性。更有趣的是，沙利度胺已显示出抑制肿瘤坏死因子α（TNFα）产生以及改变TNFα诱导的内皮细胞和人类白细胞上黏附分子表达的能力。沙利度胺已用于多种疾病（如皮肤病、自身免疫性疾病、胃肠道疾病）。在本综述中，我们特别关注该药物在具有风湿病特征的疾病中的应用，如红斑狼疮、类风湿性关节炎和斯蒂尔病、强直性脊柱炎以及白塞病。尽管沙利度胺有众所周知的副作用，首先是周围神经受累和致畸作用，而遵循严格的指导原则可避免这些副作用，但在某些风湿病情况下，沙利度胺可能是一种替代药物，特别是对于那些对其他传统治疗有耐药性、禁忌或毒性反应的患者。
