van der Woude D, Huizinga T W J
Leiden University Medical Center, Department of Rheumatology, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
Best Pract Res Clin Rheumatol. 2008 Apr;22(2):299-310. doi: 10.1016/j.berh.2008.01.009.
Findings from basic research in combination with precise clinical observations of the disease course in rheumatoid arthritis (RA) have led to the development of a multistage model to explain the pathophysiology of RA. Different cellular and soluble mediators, which play principal roles at different phases of the disease, have been identified. New therapeutic agents, which specifically target these factors, now allow us to intervene at several levels of the pathogenesis. This has already resulted in significant improvements for patients suffering from RA, and the development of new promising agents continues at a high pace. However, many questions concerning the optimal use of the new therapies remain unanswered. Combined efforts of basic research and clinical trials investigating the optimal timing and combination of the new treatments will be necessary to allow them to achieve their full potential and to result in the maximum benefit for patients.
类风湿关节炎(RA)基础研究的结果与对疾病进程的精确临床观察相结合,促成了一个多阶段模型的建立,用以解释RA的病理生理学。已确定了在疾病不同阶段发挥主要作用的不同细胞和可溶性介质。专门针对这些因素的新型治疗药物,使我们能够在发病机制的多个层面进行干预。这已经给RA患者带来了显著改善,并且新型有前景药物的研发仍在快速推进。然而,许多关于新疗法最佳使用方式的问题仍未得到解答。基础研究和临床试验需要共同努力,研究新治疗方法的最佳时机和联合使用方式,以使这些疗法充分发挥潜力,为患者带来最大益处。