Saraceno Rosita, Chimenti Sergio
Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.
Dermatol Ther. 2008 May-Jun;21(3):180-6. doi: 10.1111/j.1529-8019.2008.00189.x.
Biologic agents are immunosuppressants that target cytokines or specific immune cell subpopulations. Many therapies interfere with the normal inflammatory cascade and with the immune system, causing an increase in the incidence of infections. In particular, treatment with tumor necrosis factor (TNF)-alpha antagonists in psoriasis patients is associated with an increased risk of infection caused by intracellular microorganisms. TNF-alpha plays an important role in host resistance against infectious and several cases of Mycobacterium tuberculosis, Listeria monocytogenes, and Pneumocystis carinii have been reported with anti-TNF-alpha agents. Furthermore, B and T cells are essential to the immune response; thus, their specific reduction or inhibition by targeting molecules in T-cell cutaneous lymphomas and psoriasis could increase the risk for viral, fungal, and bacterial infections. A prompt and appropriate management of infections with the emergence of biologics is essential in clinical practice.
生物制剂是靶向细胞因子或特定免疫细胞亚群的免疫抑制剂。许多疗法会干扰正常的炎症级联反应和免疫系统，导致感染发生率增加。特别是，银屑病患者使用肿瘤坏死因子（TNF）-α拮抗剂治疗与细胞内微生物引起的感染风险增加有关。TNF-α在宿主抵抗感染中起重要作用，已有使用抗TNF-α药物导致几例结核分枝杆菌、单核细胞增生李斯特菌和卡氏肺孢子虫感染的报道。此外，B细胞和T细胞对免疫反应至关重要；因此，在皮肤T细胞淋巴瘤和银屑病中通过靶向分子特异性减少或抑制它们可能会增加病毒、真菌和细菌感染的风险。在临床实践中，随着生物制剂的出现，对感染进行及时和适当的管理至关重要。
