Teklenburg Gijs, Albani Salvatore
Department of Medicine and Pediatrics, University of California-San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0731, USA.
Curr Rheumatol Rep. 2004 Dec;6(6):434-41. doi: 10.1007/s11926-004-0022-3.
It has become increasingly clear that the innate and adaptive arms of the immune response cooperate in generating autoimmune damage in the pathogenesis of rheumatoid arthritis and juvenile idiopathic arthritis. Treatment targets the immunologic pathophysiology of the disease and is based on regaining immune tolerance. Recently introduced biological agents neutralize or simply block cytokines and their proinflammatory pathways, with favorable clinical outcome. However, major downsides are their lack of specificity and the need of continuous administration to be effective. Possibly, more can be gained from a specific approach. Indeed, recent findings suggest that targeting antigen-specific T cells can reinstate regulatory mechanisms and thus induce immune tolerization. This improved understanding has paved the way to novel immunotherapeutic approaches, some of which will be discussed here.
越来越清楚的是，在类风湿性关节炎和青少年特发性关节炎的发病机制中，免疫反应的先天性和适应性分支在产生自身免疫损伤方面相互协作。治疗针对该疾病的免疫病理生理学，并基于恢复免疫耐受。最近引入的生物制剂可中和或简单阻断细胞因子及其促炎途径，临床效果良好。然而，主要缺点是它们缺乏特异性，并且需要持续给药才能有效。可能从一种特异性方法中获得更多益处。事实上，最近的研究结果表明，靶向抗原特异性T细胞可以恢复调节机制，从而诱导免疫耐受。这种更好的理解为新型免疫治疗方法铺平了道路，本文将讨论其中一些方法。
