Morais Sandra A, Vilas-Boas Andreia, Isenberg David A
Internal Medicine Department, Hospital Pedro Hispano, Matosinhos, Portugal.
Centre for Rheumatology, University College London, Room 424, 4th Floor Rayne Building, 5 University Street, London WC1E 6JF, UK.
Ther Adv Musculoskelet Dis. 2015 Aug;7(4):122-51. doi: 10.1177/1759720X15586782.
Autoimmune rheumatic disorders have complex etiopathogenetic mechanisms in which B cells play a central role. The importance of factors stimulating B cells, notably the B-cell activating factor (BAFF) and A proliferation inducing ligand (APRIL) axis is now recognized. BAFF and APRIL are cytokines essential for B-cell proliferation and survival from the immature stages to the development of plasma cells. Their levels are increased in some subsets of patients with autoimmune disorders. Several recent biologic drugs have been developed to block this axis, namely belimumab [already licensed for systemic lupus erythematosus (SLE) treatment], tabalumab, atacicept and blisibimod. Many clinical trials to evaluate the safety and efficacy of these drugs in several autoimmune disorders are ongoing, or have been completed recently. This review updates the information on the use of biologic agents blocking BAFF/APRIL for patients with SLE, rheumatoid arthritis, Sjögren's syndrome and myositis.
自身免疫性风湿性疾病具有复杂的病因发病机制,其中B细胞发挥核心作用。目前已认识到刺激B细胞的因素的重要性,尤其是B细胞活化因子(BAFF)和增殖诱导配体(APRIL)轴。BAFF和APRIL是B细胞从未成熟阶段到浆细胞发育过程中增殖和存活所必需的细胞因子。在一些自身免疫性疾病患者的亚组中,它们的水平会升高。最近已开发出几种生物药物来阻断该轴,即贝利木单抗(已获许可用于治疗系统性红斑狼疮)、他巴鲁单抗、阿他西普和布利西莫德。目前正在进行或最近已完成多项评估这些药物在几种自身免疫性疾病中的安全性和有效性的临床试验。本综述更新了关于使用阻断BAFF/APRIL的生物制剂治疗系统性红斑狼疮、类风湿性关节炎、干燥综合征和肌炎患者的信息。
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