Division of Pediatric Allergy, Immunology, and Rheumatology, University of California at San Diego, and Rady Children's Hospital of San Diego, La Jolla, Calif.
Division of Pediatric Allergy, Immunology, and Rheumatology, University of California at San Diego, and Rady Children's Hospital of San Diego, La Jolla, Calif.
J Allergy Clin Immunol. 2016 Jul;138(1):3-14. doi: 10.1016/j.jaci.2016.05.001. Epub 2016 May 17.
Autoinflammatory diseases are disorders of the innate immune system, characterized by systemic inflammation often driven by inflammasomes, and independent of infection and autoreactive antibodies or antigen-specific T cells. These diseases are increasingly recognized as disorders of immune dysregulation, presenting with a constellation of fevers, rashes, and mucosal symptoms in many cases, which suggests that the allergist/immunologist is the appropriate specialist for these patients. However, many practicing physicians are unaware of these disorders in their pediatric and adult patient populations, leading to substantial delays in diagnosis. Recognizing autoinflammatory disease symptom patterns, performing appropriate diagnostic tests, and instituting early effective therapy are essential to reduce morbidity and mortality in these patients. This review will focus on understanding the molecular basis of inflammasomes, recognizing the distinguishing features of the classic autoinflammatory disorders, and appreciating the treatment modalities available.
自身炎症性疾病是先天免疫系统的疾病,其特征是全身性炎症,通常由炎性小体驱动,与感染、自身反应性抗体或抗原特异性 T 细胞无关。这些疾病越来越被认为是免疫失调的疾病,在许多情况下表现为发热、皮疹和黏膜症状的综合征,这表明变态反应学家/免疫学家是这些患者的合适专家。然而,许多执业医师在其儿科和成年患者人群中并未意识到这些疾病,导致诊断延迟。认识自身炎症性疾病的症状模式,进行适当的诊断测试,并尽早实施有效的治疗,对于降低这些患者的发病率和死亡率至关重要。这篇综述将重点介绍理解炎性小体的分子基础,识别经典自身炎症性疾病的特征,并了解可用的治疗方式。