Raychaudhuri Siba P, Raychaudhuri Smriti K
Department of Immunology and Rheumatology, VA Medical Center, Sacramento, CA, USA.
Indian J Dermatol. 2009;54(2):100-9. doi: 10.4103/0019-5154.53175.
Biologics are becoming important in the treatment of systemic and cutaneous autoimmune diseases. They are designed to target specific components of immune system. As the new drugs are capable of targeting proteins in a more specific fashion, yet have lower risks of systemic side-effects, they have considerable advantages over the older immunomodulators. The development of TNF-alpha blockers in the treatment of psoriasis, psoriatic arthritis, rheumatoid arthritis, Crohn's disease and ankylosing spondylitis have been major breakthroughs. Likewise, B-cell depletion has proved to be equally revolutionary for the treatment of lupus, pemphigus, certain vasculitides etc. But all said and done, the development of these molecules and their clinical usage are still at evolving stages. Consensus needs be formed to further categorize the clinical profiles of the patients in whom biologics are to be used in the future, given that the long-term safety profiles of these agents are very much unknown at present.
生物制剂在系统性和皮肤自身免疫性疾病的治疗中变得越来越重要。它们旨在靶向免疫系统的特定成分。由于这些新药能够以更具特异性的方式靶向蛋白质,且全身副作用风险较低,因此与 older immunomodulators相比具有相当大的优势。肿瘤坏死因子-α 阻滞剂在银屑病、银屑病关节炎、类风湿性关节炎、克罗恩病和强直性脊柱炎治疗中的开发是重大突破。同样,B细胞耗竭已被证明在狼疮、天疱疮、某些血管炎等疾病的治疗中同样具有革命性。但总而言之,这些分子的开发及其临床应用仍处于不断发展的阶段。鉴于目前这些药物的长期安全性尚不明确,需要形成共识,以便进一步对未来使用生物制剂的患者的临床特征进行分类。