Crommelin Heleen A, Vorselaars Adriane D M, van Moorsel Coline H M, Korenromp Ingrid H E, Deneer Vera H M, Grutters Jan C
Centre of Interstitial Lung Diseases, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands.
Immunotherapy. 2014;6(10):1127-43. doi: 10.2217/imt.14.65.
Sarcoidosis is a systemic disease with an incidence of 1 to 40 per 100 000 persons per year. It predominantly affects people in the age of 20 to 40 years old. Disease course varies from mild self-limiting to chronic debilitating and life-threatening disease. Since the cause of sarcoidosis is unknown, curative therapy is not available. Immunosuppressive drugs may, however, control the symptoms of the disease. The hallmark of sarcoidosis is the formation of granulomas that are most commonly found in lungs and lymph nodes. As TNF plays an important role in both formation and maintenance of these granulomas, as well as in the immune response, anti-TNF biologicals such as infliximab and adalimumab are considered a last resort therapeutic option. Clinical effectiveness, however, varies considerably and data showing which patients would benefit most from this expensive therapy are scarce. This review summarizes current knowledge on anti-TNF therapeutics in sarcoidosis, and describes insights on prediction of response, outcome measures and antibody development.
结节病是一种全身性疾病，每年发病率为每10万人中有1至40人。它主要影响20至40岁的人群。疾病进程从轻度自限性到慢性衰弱性及危及生命的疾病不等。由于结节病的病因不明，尚无治愈性疗法。然而，免疫抑制药物可能控制该疾病的症状。结节病的标志是肉芽肿形成，最常见于肺部和淋巴结。由于肿瘤坏死因子（TNF）在这些肉芽肿的形成和维持以及免疫反应中都起重要作用，因此英夫利昔单抗和阿达木单抗等抗TNF生物制剂被视为最后的治疗选择。然而，临床疗效差异很大，且显示哪些患者将从这种昂贵疗法中获益最多的数据很少。本综述总结了目前关于结节病抗TNF治疗的知识，并描述了关于反应预测、结局指标和抗体开发的见解。
