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[变应性肉芽肿性血管炎的更新]

[Update Churg-Strauss syndrome].

作者信息

Moosig F, Hellmich B

机构信息

Klinik für Rheumatologie und Immunologie, Klinikum Bad Bramstedt GmbH, Universitätsklinikum Schleswig Holstein, Oskar-Alexander-Str. 26, 24576, Bad Bramstedt, Deutschland.

出版信息

Z Rheumatol. 2012 Nov;71(9):765-70. doi: 10.1007/s00393-012-0985-9.

Abstract

The Churg-Strauss syndrome (CSS) is the rarest subtype of the so-called anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) and has the lowest frequency of ANCA-positivity (around 30%). In addition to asthma and blood eosinophilia, CSS is characterized by end-organ damage, which can be caused by either vasculitis and/or tissue infiltration of eosinophilic granulocytes. The CSS shares many etiological and clinical features of other hypereosinophilic syndromes. Recently, a distinct genetic background could be demonstrated for both the ANCA-positive and ANCA-negative subtypes of CSS as compared to the other two forms of AAV. Among other cytokines, interleukin-5 (IL-5) could be identified as a key mediator of eosinophilia. Therefore, recent clinical trials in CSS aimed to target IL-5. Outside of clinical trials, treatment of CSS is adapted to disease stage and activity, as recommended for other types of AAV.

摘要

变应性肉芽肿性血管炎(CSS)是所谓抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)中最罕见的亚型,ANCA阳性率最低(约30%)。除哮喘和血液嗜酸性粒细胞增多外,CSS的特征还包括终末器官损伤,这可能由血管炎和/或嗜酸性粒细胞的组织浸润引起。CSS与其他嗜酸性粒细胞增多综合征有许多病因和临床特征。最近发现,与其他两种形式的AAV相比,CSS的ANCA阳性和ANCA阴性亚型都有独特的遗传背景。在其他细胞因子中,白细胞介素-5(IL-5)被确定为嗜酸性粒细胞增多的关键介质。因此,最近针对CSS的临床试验旨在靶向IL-5。在临床试验之外,CSS的治疗根据疾病阶段和活动情况进行调整,这与其他类型的AAV的治疗建议相同。

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