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格林-巴利综合征中的生物药物治疗:最新进展。

Biological Drugs in Guillain-Barré Syndrome: An Update.

机构信息

School of Medicine, Tehran University of Medical Sciences, Tehran. Iran.

Department of Neurology, Massachusetts General Hospital, Boston, MA. United States.

出版信息

Curr Neuropharmacol. 2017;15(7):938-950. doi: 10.2174/1570159X14666161213114904.

Abstract

BACKGROUND

Guillain-Barré Syndrome (GBS) is currently considered the most common global cause of acute flaccid paralysis. Currently, standard therapy for Guillain-Barré Syndrome includes intravenous immunoglobulin or plasma exchange. Despite medical advances regarding these treatments, many treated patients do not reach full recovery. Therefore several biological agents have attracted the attentions from researchers during the last decades, and various studies have investigated their role in Guillain-Barré Syndrome.

OBJECTIVE

The present study aims to address emerging biological approaches to GBS while considering their efficiency and safety in treating the disease.

MATERIALS AND METHODS

An extensive electronic literature search was conducted by two researchers from April 2016 to July 2016. Original articles, clinical trials, systematic reviews (with or without meta-analysis) and case reports were selected. Titles and abstracts of papers were screened by reviewers to determine whether they met the eligibility criteria, and full texts of the selected articles were retrieved.

RESULTS

Herein authors focused on the literature data concerning emerging biological therapeutic agents, namely anti-C5 monoclonal antibody (Eculizumab), anti-C1q monoclonal antibody, anti-T cell monoclonal antibody, anti-CD2 monoclonal antibody, anti L-selectin monoclonal antibody, anti- CD20 monoclonal antibody (Rituximab), anti-CD52 monoclonal antibody (Alemtuzumab) and cytokine targets. By far, none of these agents have been approved for the treatment of GBS by FDA.

CONCLUSION

Literature findings represented in current review herald promising results for using these biological targets. Current review represents a summary of what is already in regards and what progress is required to improve the immunotherapeutic approach of treating GBS via future studies.

摘要

背景

吉兰-巴雷综合征(GBS)目前被认为是全球最常见的急性弛缓性瘫痪的病因。目前,吉兰-巴雷综合征的标准治疗包括静脉注射免疫球蛋白或血浆置换。尽管在这些治疗方法上取得了医学进步,但许多接受治疗的患者并未完全康复。因此,在过去的几十年中,几种生物制剂引起了研究人员的关注,并且已经有各种研究调查了它们在吉兰-巴雷综合征中的作用。

目的

本研究旨在探讨治疗吉兰-巴雷综合征的新兴生物学方法,并考虑其治疗疾病的效率和安全性。

材料和方法

两位研究人员于 2016 年 4 月至 2016 年 7 月进行了广泛的电子文献检索。选择了原始文章、临床试验、系统评价(无论是否进行荟萃分析)和病例报告。审查员筛选了论文的标题和摘要,以确定它们是否符合入选标准,并检索了所选文章的全文。

结果

本文作者重点关注有关新兴生物治疗剂的文献数据,即抗 C5 单克隆抗体(依库珠单抗)、抗 C1q 单克隆抗体、抗 T 细胞单克隆抗体、抗 CD2 单克隆抗体、抗 L-选择素单克隆抗体、抗 CD20 单克隆抗体(利妥昔单抗)、抗 CD52 单克隆抗体(阿仑单抗)和细胞因子靶点。迄今为止,这些药物均未被 FDA 批准用于治疗 GBS。

结论

当前综述中的文献结果预示着使用这些生物靶标具有有希望的结果。当前综述代表了已经在研究中的内容的总结,以及为了通过未来的研究来改善治疗 GBS 的免疫治疗方法而需要取得的进展。

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本文引用的文献

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Cochrane Database Syst Rev. 2014 Sep 19;2014(9):CD002063. doi: 10.1002/14651858.CD002063.pub6.

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