Toubi Elias, Kessel Aharon, Bamberger Ellen, Golan Theo Dov
Division of Clinical Immunology, Bnai-Zion Medical Center, P.O. Box 4940, Haifa 31048, Israel.
Curr Treat Options Cardiovasc Med. 2004 Apr;6(2):87-97. doi: 10.1007/s11936-004-0036-1.
The development of systemic lupus erythematosus (SLE) vasculitis is of prognostic value. The earlier the vasculitis is treated, the better the prognosis for SLE. Cutaneous vasculitis is common in SLE, whereas visceral vasculitis is rare. Skin SLE vasculitis is successfully treated with antimalarials, but its discontinuation may result in an SLE flare even among patients in remission. When visceral SLE vasculitis is encountered, or when a disease state is perceived to be life-threatening, a more aggressive therapy is warranted. A combination of medications, plasmapheresis, and intravenous immunoglobulin treatment, along with high-dose steroids and cytotoxic drugs, are typically employed in the treatment of severe SLE vasculitis. Finally, patients with SLE vasculitis may benefit from a number of autoimmune disease therapies currently under investigation, such as switching cytokine responses from Th1 to Th2, and the manipulation of toll-like receptors, chemokines, and FcR receptors. Specific B-cell therapies (eg, anti-Blys, B-cell depletion) may also emerge as potential treatments for SLE vasculitis.
系统性红斑狼疮（SLE）血管炎的发展具有预后价值。血管炎治疗越早，SLE的预后越好。皮肤血管炎在SLE中很常见，而内脏血管炎则很少见。皮肤SLE血管炎用抗疟药治疗成功，但即使在缓解期患者中停用抗疟药也可能导致SLE病情复发。当遇到内脏SLE血管炎或认为疾病状态危及生命时，需要更积极的治疗。药物联合、血浆置换和静脉注射免疫球蛋白治疗，以及大剂量类固醇和细胞毒性药物，通常用于治疗严重的SLE血管炎。最后，SLE血管炎患者可能受益于目前正在研究的多种自身免疫性疾病疗法，例如将细胞因子反应从Th1转换为Th2，以及对Toll样受体、趋化因子和FcR受体的调控。特异性B细胞疗法（例如，抗Blys、B细胞清除）也可能成为SLE血管炎的潜在治疗方法。
