Eleftheriou Despina, Dillon Michael J, Brogan Paul A
Department of Paediatric Rheumatology, Institute of Child Health and Great Ormond St Hospital for Children, London, UK.
Curr Opin Rheumatol. 2009 Jul;21(4):411-8. doi: 10.1097/BOR.0b013e32832c49f2.
To provide an update on new developments in paediatric vasculitis.
New classification criteria for childhood vasculitis have recently been proposed and are currently undergoing validation. Infectious triggers are still implicated in the aetiopathogenesis of Kawasaki disease and Henoch-Schonlein purpura. Several genetic polymorphisms in vasculitides have now been described that may be relevant in terms of disease predisposition or development of disease complications. Treatment regimens continue to improve, with the use of different immunosuppressive medications and newer therapeutic approaches such as biologic agents. However, new challenges are looming with regard to the role of inflammation in endothelial health and the long-term cardiovascular morbidity for children with primary systemic vasculitis.
As our understanding of disease pathogenesis in vasculitis of the young has advanced, novel therapeutic approaches have been adapted. International multicentre collaboration is of great importance to further increase and standardize the scientific base of investigating and treating childhood vasculitis.
提供儿科血管炎新进展的最新情况。
近期已提出儿童血管炎的新分类标准,目前正在进行验证。感染诱因仍与川崎病和过敏性紫癜的发病机制有关。现已描述了血管炎中的几种基因多态性,这可能与疾病易感性或疾病并发症的发生有关。治疗方案不断改进,采用了不同的免疫抑制药物和生物制剂等新的治疗方法。然而,炎症在内皮健康中的作用以及原发性系统性血管炎患儿的长期心血管发病率方面正面临新的挑战。
随着我们对儿童血管炎发病机制的认识不断深入,新的治疗方法不断涌现。国际多中心合作对于进一步加强和规范儿童血管炎的研究及治疗科学基础至关重要。