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青少年特发性关节炎的发病机制与治疗进展

Update on the pathogenesis and treatment of juvenile idiopathic arthritis.

作者信息

Giancane Gabriella, Alongi Alessandra, Ravelli Angelo

机构信息

Università degli Studi di Genova and Istituto Giannina Gaslini, Genoa, Italy.

出版信息

Curr Opin Rheumatol. 2017 Sep;29(5):523-529. doi: 10.1097/BOR.0000000000000417.

Abstract

PURPOSE OF REVIEW

To provide an overview of recently published studies on pathogenesis and management of juvenile idiopathic arthritis (JIA).

RECENT FINDINGS

In the past year, the potential role of network analysis in the understanding of the molecular phenotype of individual JIA subgroups has been highlighted. In addition, potential new targets for pharmacologic interventions have been identified through the elucidation of mechanisms that modulate the function of cells involved in the inflammatory process. There is a growing interest for the role of the gut microbiome in disease pathogenesis, which may open the way to future therapeutic manipulations of fecal microbial population. Recent therapeutic studies have provided important information in large patient samples on the effectiveness and toxicity profile of biologic medications used in JIA. Concomitant administration of methotrexate was found to increase the effectiveness of intra-articular corticosteroid therapy in children with oligoarticular JIA.

SUMMARY

A great deal of work is being conducted to better define the molecular phenotype of the individual subsets of JIA and to identify potential new targets for therapeutic interventions. The results of the ongoing large-scale international data collections will help establish the long-term safety profiles of biologic medications, in particular the risk of malignancy.

摘要

综述目的

概述近期发表的关于幼年特发性关节炎(JIA)发病机制与治疗的研究。

最新发现

过去一年,网络分析在理解各JIA亚组分子表型中的潜在作用得到凸显。此外,通过阐明调节炎症过程中相关细胞功能的机制,已确定了潜在的药物干预新靶点。肠道微生物群在疾病发病机制中的作用日益受到关注,这可能为未来粪便微生物群的治疗性调控开辟道路。近期的治疗研究在大量患者样本中提供了关于JIA生物制剂有效性和毒性特征的重要信息。发现甲氨蝶呤与关节内皮质类固醇疗法联合使用可提高寡关节型JIA患儿的治疗效果。

总结

目前正在开展大量工作,以更好地界定JIA各亚组的分子表型,并确定治疗干预的潜在新靶点。正在进行的大规模国际数据收集结果将有助于确立生物制剂的长期安全性,尤其是恶性肿瘤风险。

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