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风湿病学和临床免疫学中的独特主题和问题。

Unique topics and issues in rheumatology and clinical immunology.

机构信息

Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA, USA,

出版信息

Clin Rev Allergy Immunol. 2014 Aug;47(1):1-5. doi: 10.1007/s12016-014-8441-z.

Abstract

Clinicians are facing unexpected issues in everyday practice, and these may become counterintuitive or challenging. Illustrative examples are provided by the hypersensitivity to universally used immunosuppressants such as corticosteroids or antibiotics such as beta-lactam. Secondly, additional issues are represented by the discovery of new pathogenetic mechanisms involved in rheumatoid and psoriatic arthritis or other chronic inflammatory diseases, genomic susceptibility to enigmatic diseases such as giant cell arteritis, or the shared role of specific mediators such as semaphorins. Third, the therapeutic armamentarium has dramatically changed over the past decade following the introduction of biotechnological drugs, and new mechanisms are being proposed to reduce adverse events or increase the drug effectiveness, particularly on cardiovascular comorbidities. Finally, rare diseases continue to represent difficult cases, as for Cogan's syndrome, with limited literature available for clinical recommendations. For these reason, the present issue of Clinical Reviews in Allergy and Immunology is timely and dedicated to these and other unique topics in clinical immunology and allergy. The aim of this issue is thus to help clinicians involved in internal medicine as well as allergists and clinical immunologists while discussing new pathways that will prove important in the near future.

摘要

临床医生在日常实践中面临着意想不到的问题,这些问题可能会变得违背直觉或具有挑战性。普遍使用的免疫抑制剂(如皮质类固醇或抗生素,如β-内酰胺)的过敏反应就是一个例证。其次,新的发病机制的发现也带来了额外的问题,如类风湿关节炎和银屑病关节炎或其他慢性炎症性疾病、巨细胞性动脉炎等神秘疾病的基因组易感性,或特定介质(如 semaphorins)的共同作用。第三,随着生物技术药物的引入,过去十年中的治疗方法发生了巨大变化,提出了新的机制来减少不良反应或提高药物效果,特别是在心血管合并症方面。最后,罕见疾病仍然是一个难题,例如 Cogan 综合征,临床建议的可用文献有限。出于这些原因,本期《过敏与免疫学临床评论》及时关注了这些问题和临床免疫学和过敏领域的其他独特主题。本期刊的目的是帮助参与内科的临床医生、过敏症专家和临床免疫学家,同时讨论在不久的将来将被证明重要的新途径。

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