Paran Daphna, Naparstek Yaakov
Isr Med Assoc J. 2015 Feb;17(2):98-103.
In the past decade we have witnessed a dramatic change in the management of autoimmune diseases, such as rheumatoid arthritis, due to the development of new biologic drugs designed to target key mediators in the autoimmune process. However, the development of similar target-specific drugs for the management of SLE has not been as successful. The B cell has long been considered central to the pathogenesis of SLE and has been regarded as an important target for biologic drugs. Several B cell-targeted drugs have been developed and although the mechanisms seem promising, most of the studies published to date have failed to achieve their primary endpoints, leading to an ongoing debate regarding the role of B cell therapy in SLE. The present report discusses the pros and cons of B cell-targeted therapy in SLE, reviews the clinical studies, and offers possible explanations forthe discrepancies between randomized control studies and real-life experience.
在过去十年中，由于旨在靶向自身免疫过程中关键介质的新型生物药物的开发，我们目睹了自身免疫性疾病（如类风湿性关节炎）管理方面的巨大变化。然而，开发用于治疗系统性红斑狼疮（SLE）的类似靶向特异性药物却没有那么成功。长期以来，B细胞一直被认为是SLE发病机制的核心，并被视为生物药物的重要靶点。已经开发了几种B细胞靶向药物，尽管其作用机制似乎很有前景，但迄今为止发表的大多数研究都未能达到其主要终点，这引发了关于B细胞疗法在SLE中作用的持续争论。本报告讨论了SLE中B细胞靶向治疗的利弊，回顾了临床研究，并对随机对照研究与实际临床经验之间的差异提供了可能的解释。
