Sánchez-Ramón Silvia, López-Longo Francisco Javier, Carreño Luis
Servicio de Inmunología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Reumatol Clin. 2011 Mar;6S3:S20-4. doi: 10.1016/j.reuma.2010.11.010. Epub 2011 Mar 23.
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by synovitis and progressive destruction of the joint cartilage and underlying bone, together with diverse extra-articular manifestations. Cytokines act as soluble effector mediators of the inflammatory process. Therapeutic neutralization with monoclonal antibodies against the pro-inflammatory cytokines TNF-alpha and interleukin 1 (IL-1) has shown a clear efficacy on inflammation and clinical manifestations of RA, although a percentage of patients do not respond. This review covers new relevant cytokines in the RA physiopathology and potential biomarkers of inflammation. The current challenge is to develop biomarkers that enable an earlier diagnosis, as well as prognostic markers and new therapeutic candidates. Combined administration of several of these cytokines could eventually address a personalized treatment approach for each patient.
类风湿性关节炎(RA)是一种全身性自身免疫性疾病,其特征为滑膜炎、关节软骨及深层骨质的进行性破坏,以及多种关节外表现。细胞因子作为炎症过程的可溶性效应介质。用抗促炎细胞因子肿瘤坏死因子-α(TNF-α)和白细胞介素1(IL-1)的单克隆抗体进行治疗性中和,已显示出对RA的炎症和临床表现有明显疗效,尽管有一定比例的患者无反应。本综述涵盖了RA生理病理学中的新相关细胞因子以及潜在的炎症生物标志物。当前的挑战是开发能够实现早期诊断的生物标志物,以及预后标志物和新的治疗候选物。联合使用其中几种细胞因子最终可能为每位患者提供个性化的治疗方法。