Kulczycka Lilianna, Kierstan Monika K, Sysa-Jedrzejowska Anna, Robak Ewa
Klinika Dermatologii i Wenerologii Uniwersytetu Medycznego w Łodzi.
Przegl Lek. 2007;64(7-8):509-14.
Drug-induced lupus (DIL) is a lupus-like syndrome. Its clinical and laboratory features are very similar to idiopathic lupus. First description of DIL is from 1945. Since that time over 80 medications are known to be responsible for development of the disease. Nevertheless mechanisms responsible for this process are not known enough. Nowadays direct and indirect mechanisms in DIL are known. The slow acetylator status has an important position. Moreover the role of estrogens and anti-TNF-alpha therapy are taken into consideration. The T cells' participation and the methylation of DNA and their role in graft-vs.-host disease, which is the murine model for DIL, are considered among others. Researches point also to the LFA-1 and the IL-6 as factors responsible for DIL's development. Another element which could be significant in this process is the presence of antimielo-peroxydase antibodies. Also the role of disruption of T-cell maturation in the thymus induced by the drugs' metabolites may have an important position. Nevertheless it is still very hard to say which of those mechanisms is the main one. In spite of everything it's not clear enough if the observed clinical manifestations are caused by drugs/their metabolites,- DIL or that they are consequences of a induction of silent process leading to SLE development.
药物性狼疮（DIL）是一种狼疮样综合征。其临床和实验室特征与特发性狼疮非常相似。DIL的首次描述始于1945年。自那时以来，已知有80多种药物可导致该疾病的发生。然而，导致这一过程的机制尚不完全清楚。如今，已知DIL存在直接和间接机制。慢乙酰化状态具有重要地位。此外，雌激素和抗TNF-α治疗的作用也被考虑在内。T细胞的参与以及DNA甲基化及其在移植物抗宿主病（DIL的小鼠模型）中的作用等也被提及。研究还指出LFA-1和IL-6是导致DIL发生的因素。在此过程中可能具有重要意义的另一个因素是抗髓过氧化物酶抗体的存在。药物代谢产物诱导胸腺中T细胞成熟受阻的作用也可能具有重要地位。然而，仍然很难说这些机制中哪一个是主要的。尽管如此，尚不清楚观察到的临床表现是由药物/其代谢产物、DIL引起的，还是它们是导致系统性红斑狼疮（SLE）发生的沉默过程诱导的结果。
