Bazsó Anna, Poór Gyula, Gergely Péter, Kiss Emese
Országos Reumatológiai és Fizioterápiás Intézet, Budapest.
Orv Hetil. 2010 May 2;151(18):735-40. doi: 10.1556/OH.2010.28863.
Systemic lupus erythematosus (SLE) is an autoimmune disorder involving different organs and organ systems with consequent characteristic clinical and serologic symptoms. Despite of the improvement in lupus survival, approximately 10-20% of patients do not respond to traditional immune suppressive therapies. Relapses are more frequent; e.g. after cyclophosphamide therapy diffuse proliferative nephritis flares in 1/3 of patients. Different immune competent cells and inflammatory mediators participate in the pathogenesis of SLE involving both the adaptive and innate immunity. Several pathogenic elements and mechanisms may serve as therapeutic targets, consequently. Authors summarize novel therapeutic possibilities and their mechanisms regarding the pathogenesis of SLE. Immune modulation of B and T cells, co-stimulatory pathways, cytokine network, soluble mediators and autologous hemopoietic stem cell transplantation are discussed.
系统性红斑狼疮(SLE)是一种自身免疫性疾病,累及不同器官和器官系统,从而产生典型的临床和血清学症状。尽管狼疮患者的生存率有所提高,但仍有大约10%-20%的患者对传统免疫抑制疗法无反应。复发更为频繁,例如在环磷酰胺治疗后,三分之一的患者会出现弥漫性增殖性肾炎发作。不同的免疫活性细胞和炎症介质参与了SLE的发病机制,涉及适应性免疫和固有免疫。因此,几种致病因素和机制可能成为治疗靶点。作者总结了关于SLE发病机制的新型治疗可能性及其机制。讨论了B细胞和T细胞的免疫调节、共刺激途径、细胞因子网络、可溶性介质和自体造血干细胞移植。