Frey Felix J
Klinik und Poliklinik für Nephrologie und Hypertonie, Inselspital, Bern.
Ther Umsch. 2008 May;65(5):247-51. doi: 10.1024/0040-5930.65.5.247.
The polyarteritis nodosa is a vasculitis for which the main cause had been identified as hepatitis B, a chronic infectious disease inducing an overshooting immune reaction. Thanks to this discovery, the treatment of polyarteritis nodosa has changed from a symptomatic immunosuppressive therapy to a treatment strategy focusing on the disease inducing infectious agent. Vaccination against hepatitis B- virus has been instrumental in the reduction of the prevalence of polyarteritis nodosa. In case of the rare entity of polyarteritis nodosa without hepatitis B, only a symptomatic immunosuppressive therapy can be prescribed. The history of polyarteritis nodosa clearly illustrates that future research in the field of so called autoimmune diseases should focus on the causes rather than on the immunologic effector mechanisms and/or the symptomatic immunosuppressive therapy.
结节性多动脉炎是一种血管炎,其主要病因已被确定为乙型肝炎,这是一种引发过度免疫反应的慢性传染病。由于这一发现,结节性多动脉炎的治疗已从对症免疫抑制疗法转变为针对引发疾病的感染因子的治疗策略。乙肝病毒疫苗接种在降低结节性多动脉炎的患病率方面发挥了重要作用。对于罕见的无乙型肝炎的结节性多动脉炎病例,只能采用对症免疫抑制疗法。结节性多动脉炎的历史清楚地表明,未来在所谓自身免疫性疾病领域的研究应侧重于病因,而非免疫效应机制和/或对症免疫抑制疗法。