Feist E, Dörner T, Hansen A
Interdisziplinäres Sjögren-Syndrom-Centrum, Berlin, Germany.
Z Rheumatol. 2007 Dec;66(8):679-85. doi: 10.1007/s00393-007-0231-z.
Sjögren's syndrome is a systemic inflammatory rheumatic disorder of unknown origin with so far inadequate therapy options. Management of Sjögren's syndrome is still primarily palliative using local symptomatic measures, and if appropriate glucocorticoids, NSAIDs and immunosuppressive drugs. New clues to the pathogenesis of this disorder pave the way for new therapeutic strategies. In particular targeting B-cells offers promising results and emphasizes the role of B-cells in the pathogenesis of this complex disorder. Rituximab was introduced into the standard treatment of different forms of low-grade and high-grade B-cell non-Hodgkins lymphomas, and is also an option for some lymphomas associated with Sjögren's syndrome. Whether interference with T-cell function is also a safe and effective strategy in Sjögren's syndrome, has to be shown in controlled clinical trials. However, there is no clear evidence to suggest that treatment with TNF-alpha blockers is efficacious in Sjögren's syndrome. Standardization of disease activity and outcome measurements are critical for further clinical trials for Sjögren's syndrome.
干燥综合征是一种病因不明的全身性炎症性风湿性疾病,目前治疗选择有限。干燥综合征的管理仍主要采用局部对症措施进行姑息治疗,必要时使用糖皮质激素、非甾体抗炎药和免疫抑制药物。该疾病发病机制的新线索为新的治疗策略铺平了道路。特别是针对B细胞显示出了有前景的结果,并强调了B细胞在这种复杂疾病发病机制中的作用。利妥昔单抗已被引入不同类型低度和高度B细胞非霍奇金淋巴瘤的标准治疗中,也是一些与干燥综合征相关淋巴瘤的治疗选择。干扰T细胞功能在干燥综合征中是否也是一种安全有效的策略,必须通过对照临床试验来证明。然而,没有明确证据表明用肿瘤坏死因子-α阻滞剂治疗干燥综合征有效。疾病活动度和结局测量的标准化对于干燥综合征的进一步临床试验至关重要。