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类风湿关节炎的治疗靶点:进展与展望。

Therapeutic targets for rheumatoid arthritis: Progress and promises.

机构信息

Department of Pharmacology and Therapeutics and.

出版信息

Autoimmunity. 2014 Mar;47(2):77-94. doi: 10.3109/08916934.2013.873413. Epub 2014 Jan 20.

Abstract

Recent therapeutic advancements in understanding of molecular and cellular mechanisms of rheumatoid arthritis (RA) have highlighted the strategies that aim to inhibit the harmful effects of up-regulated cytokines or other inflammatory mediators and to inhibit their associated signaling events. The utility of cytokine as therapeutic targets in RA has been unequivocally demonstrated by the success of tumor necrosis factor (TNF)-α blockade in clinical practice. Partial and non-responses to TNF-α blocking agents, however, together with the increasing clinical drive to remission induction, requires that further therapeutic targets be identified. Numerous proinflammatory mediators with their associated cell signaling events have now been demonstrated in RA, including interleukin (IL)-1 and IL-12 superfamilies. Continued efforts are ongoing to target IL-6, IL-15 and IL-17 in clinical trials with promising data emerging. In the present review, we focus on IL-7, IL-18, IL-32 and IL-10 family of cytokines (IL-19, IL-20 and IL-22) as they are implicated in contributing to the pathogenesis of RA, which could be targeted and offer new therapeutic options for RA therapy. Recent evidences also suggest that multiligand receptor for advanced glycation end products (RAGE), several adipokines and various components of immune system play a critical role in the pathophysiology of RA; therefore we have also highlighted them as therapeutic targets for RA therapy. Components of subcellular pathways, involve in nuclear transcription factor (NF)-κB, mitogen-activated protein kinases (MAPKs) and the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway have also been discussed and offer several novel potential therapeutic opportunities for RA.

摘要

近年来,对类风湿关节炎(RA)分子和细胞机制的理解方面的治疗进展突出了旨在抑制上调细胞因子或其他炎症介质的有害影响并抑制其相关信号事件的策略。细胞因子作为 RA 治疗靶点的效用已通过 TNF-α 阻断在临床实践中的成功得到明确证实。然而,TNF-α 阻断剂的部分和非反应性,以及向缓解诱导的临床推动力的增加,需要确定进一步的治疗靶点。现在已经在 RA 中证明了许多具有相关细胞信号事件的促炎介质,包括白细胞介素(IL)-1 和 IL-12 超家族。继续努力在临床试验中靶向 IL-6、IL-15 和 IL-17,并出现了有希望的数据。在本综述中,我们重点关注 IL-7、IL-18、IL-32 和 IL-10 细胞因子家族(IL-19、IL-20 和 IL-22),因为它们与 RA 的发病机制有关,这可能成为治疗 RA 的靶点并提供新的治疗选择。最近的证据还表明,晚期糖基化终产物(RAGE)的多配体受体、几种脂肪因子和免疫系统的各种成分在 RA 的病理生理学中起着关键作用;因此,我们也将它们作为 RA 治疗的治疗靶点。涉及核转录因子(NF)-κB、丝裂原活化蛋白激酶(MAPKs)和 Janus 激酶-信号转导和转录激活因子(JAK-STAT)途径的亚细胞途径的成分也已被讨论,并为 RA 提供了几种新的潜在治疗机会。

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