Centre d'Affaires Poincaré, Nice, France.
Oral Dis. 2013 Jan;19(1):37-45. doi: 10.1111/j.1601-0825.2012.01931.x. Epub 2012 Apr 4.
Inflammatory ulcerative diseases of the oral mucosa are wide ranging but include especially aphthous and aphthous-like ulceration, vesiculobullous disorders and erosive lichen planus (LP). While most patients with these conditions respond to conventional topical and/or systemic immunosuppressive agents, treatment-resistant cases remain challenging. In these, the use of biologics such as tumour necrosis factor alpha (TNF-α) inhibitors or rituximab may be of benefit. This article reviews the use of biologics in ulcerative oral conditions, highlighting potential benefits, adverse effects and principles of use and future developments. TNF-α inhibitors such as infliximab can be effective in inducing resolution in oral aphthous and aphthous-like ulcers and may be an appropriate therapy in those patients in which disease is severe and refractory to, or patients are intolerant of, traditional immunomodulatory regimens. There would also seem support and rationale for use of biologics (mainly rituximab) in pemphigus but not in oral LP or other oral ulcerative conditions.
口腔黏膜炎性溃疡性疾病种类繁多，但包括阿弗他溃疡和阿弗他样溃疡、水疱性和大疱性疾病以及糜烂型扁平苔藓（LP）。虽然大多数此类疾病的患者对传统的局部和/或全身免疫抑制剂有反应，但治疗抵抗的病例仍然具有挑战性。在这些病例中，使用肿瘤坏死因子-α（TNF-α）抑制剂或利妥昔单抗等生物制剂可能有益。本文综述了生物制剂在溃疡性口腔疾病中的应用，强调了潜在的益处、不良反应以及使用原则和未来的发展。英夫利昔单抗等 TNF-α 抑制剂可有效诱导口腔阿弗他溃疡和阿弗他样溃疡的愈合，对于疾病严重且对传统免疫调节方案耐药或不耐受的患者，可能是一种合适的治疗方法。在天疱疮中使用生物制剂（主要是利妥昔单抗）似乎也有支持和依据，但在口腔 LP 或其他口腔溃疡性疾病中则没有。
