免疫细胞因子:类风湿关节炎期待已久的治疗“灵丹妙药”?
Immunocytokines: the long awaited therapeutic magic bullet in rheumatoid arthritis?
出版信息
Arthritis Res Ther. 2009;11(6):132. doi: 10.1186/ar2835. Epub 2009 Nov 6.
Modulatory cytokines such as IL-4 and IL-10 looked promising biologicals, but suffered from poor exposure at the inflamed joints when administered via the patient-friendly subcutaneous route. Immunocytokines have now been engineered with tissue targeting potential and are a possible solution to this problem, although challenges still exist. Local inflammatory processes cause destruction of extracellular matrix (ECM) components, leading to neo-eptitopes, and/or elicit the synthesis of new ECM components. This makes ECM elements interesting targets for antibody-mediated recognition and retention, to achieve higher levels of immunocytokines at the site of therapeutic interference. The study presented by Schwager and colleagues shows that targeted delivery of IL-10 is more efficacious in experimental arthritis. Clinical studies are warranted to show whether this strategy works for all rheumatoid arthritis patients or is better for subgroups with a defined ECM phenotype. In principle, the scFv-targeting system is plastic enough to allow for personalized strategies.
调节性细胞因子,如 IL-4 和 IL-10,看起来是很有前途的生物制剂,但通过患者友好的皮下途径给药时,在发炎的关节中暴露度较差。免疫细胞因子现已通过工程设计具有组织靶向潜力,是解决此问题的一种可能方法,但仍存在挑战。局部炎症过程导致细胞外基质 (ECM) 成分的破坏,导致新的表位,和/或引发新的 ECM 成分的合成。这使得 ECM 元素成为抗体介导的识别和保留的有趣靶点,以在治疗干预部位实现更高水平的免疫细胞因子。Schwager 及其同事的研究表明,IL-10 的靶向递送在实验性关节炎中更有效。需要进行临床研究以确定这种策略是否适用于所有类风湿关节炎患者,或者对于具有明确 ECM 表型的亚组是否更好。原则上,scFv 靶向系统具有足够的可塑性,可以实现个性化策略。