Department of Medical Sciences, Section of Rheumatology, Uppsala University, Uppsala SE-751 85, Sweden.
Nat Rev Rheumatol. 2010 Jun;6(6):339-47. doi: 10.1038/nrrheum.2010.64. Epub 2010 May 4.
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease involving most immune cells. Studies in both experimental animal models of lupus and patients with SLE have revealed a number of cytokine pathways that are important in the disease process. Among these are B-cell activating factor, which promotes B-cell survival and autoantibody production, interferon-alpha, which acts as an immune adjuvant, and tumor necrosis factor, which contributes to organ inflammation. This knowledge, in combination with the successful use of anti-TNF treatment in rheumatoid arthritis, has spurred the development of several biologic agents targeting different cytokines or their receptors in SLE. Consequently, many trials of anticytokine therapies for SLE are underway. Although most of these trials are small or in early phases, the results of some large studies have also been reported. In this Review, we discuss the rationale for anticytokine therapies in SLE and review agents currently in use, and those being developed and tested experimentally. We present the results from published trials and discuss the tentative conclusions that can be drawn regarding the efficacy of the new agents. Finally, we provide suggestions for the future of treatment for SLE, including new therapeutic strategies.
系统性红斑狼疮（SLE）是一种涉及大多数免疫细胞的异质性自身免疫性疾病。狼疮实验动物模型和 SLE 患者的研究揭示了许多在疾病过程中起重要作用的细胞因子途径。其中包括促进 B 细胞存活和自身抗体产生的 B 细胞激活因子、作为免疫佐剂的干扰素-α，以及导致器官炎症的肿瘤坏死因子。这方面的知识，结合抗 TNF 治疗在类风湿关节炎中的成功应用，促使针对 SLE 中不同细胞因子或其受体的几种生物制剂的开发。因此，正在进行许多针对 SLE 的抗细胞因子治疗试验。尽管这些试验大多数规模较小或处于早期阶段，但一些大型研究的结果也已经报告。在这篇综述中，我们讨论了在 SLE 中使用抗细胞因子治疗的原理，并回顾了目前正在使用的以及正在开发和实验测试的药物。我们呈现了已发表试验的结果，并讨论了可以得出关于新药物疗效的暂定结论。最后，我们为 SLE 的未来治疗提供了建议，包括新的治疗策略。
