细胞因子在系统性红斑狼疮发病机制和治疗中的作用。

The role of cytokines in the pathogenesis and treatment of systemic lupus erythematosus.

机构信息

Division of Rheumatology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas 75390-8884, USA.

出版信息

J Interferon Cytokine Res. 2011 Oct;31(10):781-9. doi: 10.1089/jir.2011.0047. Epub 2011 Jul 25.

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by a defect in immune tolerance and exacerbated by both the innate and adaptive arms of the immune response. SLE-associated immune hyperactivity can be detected systemically as elevations in levels of cytokines along with their upregulated receptors expressed by hematopoietic cells. Importantly, increased levels of cytokines and their receptors can be observed in target organs, and it is clear that they have important roles in disease pathogenesis. Recent therapeutic strategies have focused on proximal cytokines, such as interferon-α, interleukin (IL)-1, IL-6, and tumor necrosis factor as a result of the efficacious use of biologic agents for intervention in rheumatoid arthritis and other autoimmune diseases. Despite the recent advances in understanding the cytokine networks involved in autoimmune diseases and more specifically in SLE, the diagnosis and prognosis of lupus remain a challenge. Lupus is heterogeneous and unpredictable; moreover, the frequency and severity of flares can be difficult to determine and treat. A better understanding of the regulation of expression of key cytokines and their receptors can likely provide important clues to the pathogenic mechanisms underlying specific forms of SLE, and pave the way toward more effective therapeutics.

摘要

系统性红斑狼疮(SLE)是一种慢性自身免疫性疾病,其特征是免疫耐受缺陷,并由先天和适应性免疫反应的两个分支加剧。SLE 相关的免疫过度活跃可以通过细胞因子水平的升高以及造血细胞表达的其上调受体来在全身检测到。重要的是,可以在靶器官中观察到细胞因子及其受体的水平增加,并且它们在疾病发病机制中具有重要作用。最近的治疗策略集中在干扰素-α、白细胞介素 (IL)-1、IL-6 和肿瘤坏死因子等近端细胞因子上,这是由于生物制剂在类风湿关节炎和其他自身免疫性疾病中的干预效果显著。尽管最近在理解参与自身免疫性疾病、更具体地说是 SLE 的细胞因子网络方面取得了进展,但狼疮的诊断和预后仍然是一个挑战。狼疮具有异质性和不可预测性;此外,爆发的频率和严重程度难以确定和治疗。更好地理解关键细胞因子及其受体表达的调节可能为特定形式的 SLE 的发病机制提供重要线索,并为更有效的治疗方法铺平道路。

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