Giasuddin A S M, Hoque M E, Ahmed Z U
Dept of Biochemistry, Medical College for Women & Hospital, Uttara, Dhaka.
Bangladesh Med Res Counc Bull. 2005 Dec;31(3):88-94.
In rheumatoid arthritis (RA), the conventional therapies (first-line, second-line, third-line drugs) provide more or less effective symptomatic relief for a decade or so from the onset of the disease. However, the chronic inflammatory destructive processes involving connective tissue, cartilage and bone with their attendant disability progress relentlessly in majority of patients. Secondly, use of 'second-line' and 'third-line' drugs in RA are limited due to their side effects. Studies in animals and RA patients have confirmed that tumour necrosis factor-alpha (TNFalpha), an inflammatory cytokine, is of major importance in the rheumatoid disease process and thus, it might be an effective therapeutic target in RA. Animal model experiments and clinical trials were conducted with anti-TNFalpha monoclonal antibody (anti-TNFalpha MoAb) in RA recently. This anti-TNFalpha MoAb therapy was found to be both effective and safe which documented the coming-of-age of cytokine-based immunointervention in RA. Researchers are optimistic that modern medicine would certainly witness the application of this noble immunotherapy enabling to selectively target cytokines, e.g. TNFalpha, in RA as well as in other inflammatory autoimmune diseases in the near future.
在类风湿关节炎（RA）中，传统疗法（一线、二线、三线药物）从疾病发作开始能在大约十年内或多或少有效地缓解症状。然而，在大多数患者中，涉及结缔组织、软骨和骨骼的慢性炎症破坏过程及其伴随的残疾会持续无情地进展。其次，由于“二线”和“三线”药物的副作用，它们在RA中的使用受到限制。对动物和RA患者的研究证实，炎症细胞因子肿瘤坏死因子-α（TNFα）在类风湿疾病过程中至关重要，因此，它可能是RA中一个有效的治疗靶点。最近在RA中用抗TNFα单克隆抗体（抗TNFα MoAb）进行了动物模型实验和临床试验。发现这种抗TNFα MoAb疗法既有效又安全，这证明了基于细胞因子的免疫干预在RA中的成熟。研究人员乐观地认为，现代医学肯定会见证这种高尚的免疫疗法在不久的将来应用于RA以及其他炎症性自身免疫性疾病，能够选择性地靶向细胞因子，如TNFα。
