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系统性硬皮病的药物治疗。

Pharmacotherapy of systemic sclerosis.

机构信息

Department of Medicine, Division of Connective Tissue Diseases, University of Tennessee Health Science Center, Room G326, Memphis, TN 38163, USA.

出版信息

Expert Opin Pharmacother. 2010 Apr;11(5):789-806. doi: 10.1517/14656561003592177.

DOI:10.1517/14656561003592177
PMID:20210685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2837533/
Abstract

IMPORTANCE OF THE FIELD

Systemic sclerosis (SSc) is an uncommon autoimmune disease with variable degrees of fibroproliferation in blood vessels and certain organs of the body. There is currently no cure. The purpose of this article is to review the current literature regarding pathogenesis and treatment of complications of SSc.

AREAS COVERED IN THIS REVIEW

All available articles regarding research related to SSc pathogenesis and treatment listed in the PubMed database were searched; relevant articles were then reviewed and used as sources of information for this review.

WHAT THE READER WILL GAIN

This review attempts to highlight for the reader some current thought regarding mechanisms of SSc pathogenesis and how autoimmunity relates to vascular changes and fibrogenesis of the disease, as well as providing a review of results of completed clinical trials and current ongoing clinical trials that address organ-specific or global therapies for this disease. This can aid physicians who provide medical care for patients with SSc.

TAKE HOME MESSAGE

SSc is a complex autoimmune disease, the pathogenesis of which, although not completely understood, is under active study; new insights into pathogenesis are continually being discovered. Although there is no effective disease-modifying treatment for patients with SSc, quality of life, morbidity and mortality can be improved by using targeted therapy directed at affecting the consequences of damage to lungs, blood vessels, kidneys and the gastrointestinal tract. Innovative approaches to treating SSc are under intense investigation.

摘要

重要性领域

系统性硬化症(SSc)是一种罕见的自身免疫性疾病,其血管和身体某些器官存在不同程度的纤维增生。目前尚无治愈方法。本文旨在回顾 SSc 并发症的发病机制和治疗的现有文献。

这篇综述涵盖的内容

在 PubMed 数据库中搜索了与 SSc 发病机制和治疗相关的所有可用研究文章;然后对相关文章进行了回顾,并将其作为本综述的信息来源。

读者将获得的收益

这篇综述试图向读者强调一些目前关于 SSc 发病机制的机制的思考,以及自身免疫与疾病的血管变化和纤维化之间的关系,并对已完成的临床试验结果和目前正在进行的临床试验进行综述,这些试验涉及针对这种疾病的特定器官或全身性治疗。这可以帮助为 SSc 患者提供医疗服务的医生。

需要注意的是

SSc 是一种复杂的自身免疫性疾病,其发病机制虽然尚未完全了解,但正在积极研究中;对发病机制的新见解不断被发现。尽管对于 SSc 患者没有有效的疾病修饰治疗方法,但通过针对肺部、血管、肾脏和胃肠道损伤后果的靶向治疗,可以改善生活质量、发病率和死亡率。治疗 SSc 的创新方法正在深入研究中。

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本文引用的文献

1
A TGFbeta-responsive gene signature is associated with a subset of diffuse scleroderma with increased disease severity.TGFbeta 反应基因特征与弥漫性硬皮病的一个亚组相关,该亚组疾病严重程度增加。
J Invest Dermatol. 2010 Mar;130(3):694-705. doi: 10.1038/jid.2009.318. Epub 2009 Oct 8.
2
Immunoglobulins from scleroderma patients inhibit the muscarinic receptor activation in internal anal sphincter smooth muscle cells.硬皮病患者的免疫球蛋白可抑制肛门内括约肌平滑肌细胞中的毒蕈碱受体激活。
Am J Physiol Gastrointest Liver Physiol. 2009 Dec;297(6):G1206-13. doi: 10.1152/ajpgi.00286.2009. Epub 2009 Sep 24.
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Elevated serum levels of arachidonoyl-lysophosphatidic acid and sphingosine 1-phosphate in systemic sclerosis.
Curr Rheumatol Rep. 2016 Feb;18(2):12. doi: 10.1007/s11926-015-0555-7.
4
Pathogenesis of Systemic Sclerosis.系统性硬化症的发病机制
Front Immunol. 2015 Jun 8;6:272. doi: 10.3389/fimmu.2015.00272. eCollection 2015.
5
Effect of menopause on the modified Rodnan skin score in systemic sclerosis.更年期对系统性硬化症改良罗德南皮肤评分的影响。
Arthritis Res Ther. 2014 Jun 23;16(3):R130. doi: 10.1186/ar4587.
6
Dose-escalation of human anti-interferon-α receptor monoclonal antibody MEDI-546 in subjects with systemic sclerosis: a phase 1, multicenter, open label study.人抗干扰素-α受体单克隆抗体MEDI-546在系统性硬化症患者中的剂量递增:一项1期多中心开放标签研究。
Arthritis Res Ther. 2014 Feb 24;16(1):R57. doi: 10.1186/ar4492.
7
CD109, a TGF-β co-receptor, attenuates extracellular matrix production in scleroderma skin fibroblasts.CD109,TGF-β 共受体,可减弱硬皮病皮肤成纤维细胞的细胞外基质产生。
Arthritis Res Ther. 2012 Jun 13;14(3):R144. doi: 10.1186/ar3877.
8
Vascular involvement in systemic sclerosis (scleroderma).系统性硬皮病(硬皮病)中的血管病变。
J Inflamm Res. 2011;4:105-25. doi: 10.2147/JIR.S18145. Epub 2011 Jul 26.
9
Canonical Wnt signaling induces skin fibrosis and subcutaneous lipoatrophy: a novel mouse model for scleroderma?经典Wnt信号通路诱导皮肤纤维化和皮下脂肪萎缩:一种用于硬皮病的新型小鼠模型?
Arthritis Rheum. 2011 Jun;63(6):1707-17. doi: 10.1002/art.30312.
系统性硬化症中血清花生四烯酰-溶血磷脂酸和鞘氨醇-1-磷酸水平升高。
Int J Med Sci. 2009 Jun 5;6(4):168-76. doi: 10.7150/ijms.6.168.
4
Cardiac complications of systemic sclerosis.系统性硬化症的心脏并发症
Rheumatology (Oxford). 2009 Jun;48 Suppl 3:iii45-8. doi: 10.1093/rheumatology/kep110.
5
Pulmonary complications: one of the most challenging complications of systemic sclerosis.肺部并发症:系统性硬化症最具挑战性的并发症之一。
Rheumatology (Oxford). 2009 Jun;48 Suppl 3:iii40-4. doi: 10.1093/rheumatology/kep109.
6
Gastrointestinal complications: the most frequent internal complications of systemic sclerosis.胃肠道并发症:系统性硬化症最常见的内部并发症。
Rheumatology (Oxford). 2009 Jun;48 Suppl 3:iii36-9. doi: 10.1093/rheumatology/ken485.
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Renal complications and scleroderma renal crisis.肾脏并发症与硬皮病肾危象
Rheumatology (Oxford). 2009 Jun;48 Suppl 3:iii32-5. doi: 10.1093/rheumatology/ken483.
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Tadalafil therapy for pulmonary arterial hypertension.他达拉非治疗肺动脉高压。
Circulation. 2009 Jun 9;119(22):2894-903. doi: 10.1161/CIRCULATIONAHA.108.839274. Epub 2009 May 26.
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No effects of bosentan on microvasculature in patients with limited cutaneous systemic sclerosis.波生坦对局限性皮肤型系统性硬化症患者微血管无影响。
Clin Rheumatol. 2009 Jul;28(7):825-33. doi: 10.1007/s10067-009-1157-4. Epub 2009 Apr 7.
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Inducible MHC class II expression by mast cells supports effector and regulatory T cell activation.肥大细胞诱导性MHC II类分子表达支持效应性和调节性T细胞活化。
J Immunol. 2009 Apr 15;182(8):4686-95. doi: 10.4049/jimmunol.0803180.