Respiratory Diseases Section, Department of Clinical Medicine and Immunology Sciences, Siena University, Le Scotte Hospital, Viale Bracci, 53100 Siena, Italy.
Rheumatol Int. 2011 Dec;31(12):1539-44. doi: 10.1007/s00296-011-1969-9. Epub 2011 Jun 5.
Sarcoidosis is a granulomatous lung disease in which several cytokines play a pivotal pathogenetic role. Steroid-resistant disease can be treated with immunosuppressive drugs, antimalarial therapies and recently with anti-TNFα agents. The use of biological agents for the treatment of sarcoidosis springs from research into the pathogenesis of the disease and also from the experience of rheumatologists with other chronic inflammatory diseases. Rituximab, golimumab and ustekinumab are cytokine modulators, useful in the treatment of immunoinflammatory disorders, for which randomized trials to evaluate safety and efficacy in sarcoidosis are not yet available. Novel anticytokine drugs administered alone or in association may offer a new approach to treatment of the disease. This review focuses on recent advances in anti-TNFα agents and cytokine modulators for the treatment of sarcoidosis and their therapeutic prospects.
结节病是一种肉芽肿性肺部疾病，其中几种细胞因子起着关键的发病作用。对于类固醇耐药性疾病，可以使用免疫抑制剂、抗疟药物，最近还可以使用抗 TNFα 药物进行治疗。生物制剂用于治疗结节病源于对疾病发病机制的研究，也源于风湿病学家对其他慢性炎症性疾病的经验。利妥昔单抗、戈利木单抗和乌司奴单抗是细胞因子调节剂，可用于治疗免疫炎症性疾病，但目前尚无评估其在结节病中的安全性和疗效的随机试验。单独或联合使用新型抗细胞因子药物可能为治疗该疾病提供新方法。本文重点介绍了抗 TNFα 药物和细胞因子调节剂治疗结节病的最新进展及其治疗前景。
