Department of Molecular and Translational Medicine, University of Brescia , Brescia , Italy .
Autoimmunity. 2014 Aug;47(5):287-306. doi: 10.3109/08916934.2014.897333. Epub 2014 Apr 3.
Chronic inflammatory diseases represent a heterogeneous group of conditions that can affect practically any organ or system. An increasing number of biologic agents have been developed to selectively target the cell populations and signaling pathways involved in chronic inflammation, including cytokines, monoclonal antibodies and engineered receptors. This approach has been remarkably successful in alleviating some of the signs and symptoms of refractory autoimmune diseases. The use of this therapeutic strategy is likely to increase with the introduction of biosimilar agents. The different nature of these biological products makes the comparison of their pharmaceutical and clinical characteristics difficult, including safety and potency and these issues may be particularly relevant in the case of biosimilars. In addition, the heterogeneity of autoimmune diseases and of autoimmune patients, further adds to the complexity of choosing the right drug for each patient and predicting efficacy and safety of the treatment. In this review, we summarize actual knowledge about current biological agents and their use in autoimmune diseases, with a special emphasis for rheumatoid arthritis, inflammatory bowel diseases and psoriasis. The purpose of this analysis is to address the most critical issues raised by the rapid advancements in this field over recent years, and to acknowledge the potentially valuable gains brought about by the increasing availability of these new biologic agents.
慢性炎症性疾病代表了一组异质性的疾病，几乎可以影响任何器官或系统。为了有针对性地靶向慢性炎症相关的细胞群体和信号通路，包括细胞因子、单克隆抗体和工程受体，已经开发出越来越多的生物制剂。这种方法在缓解一些难治性自身免疫性疾病的症状方面取得了显著的成功。随着生物类似药的引入，这种治疗策略的应用可能会增加。这些生物制品的性质不同，使得比较它们的药物和临床特性变得困难，包括安全性和效力，而在生物类似药的情况下，这些问题可能尤为重要。此外，自身免疫性疾病和自身免疫性患者的异质性，进一步增加了为每个患者选择正确药物以及预测治疗效果和安全性的复杂性。在这篇综述中，我们总结了当前生物制剂及其在自身免疫性疾病中的应用的现有知识，特别强调类风湿关节炎、炎症性肠病和银屑病。本分析的目的是解决近年来该领域快速发展所提出的最关键问题，并承认越来越多的这些新型生物制剂的应用所带来的潜在有价值的收益。
