Human Eosinophil Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Md.
Human Eosinophil Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Md.
J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1502-1509. doi: 10.1016/j.jaip.2017.08.001.
Hypereosinophilic syndromes (HES) are a heterogeneous group of rare disorders defined by the presence of marked peripheral or tissue eosinophilia resulting in end-organ damage. Although conventional therapies, including glucocorticoids, hydroxyurea, and IFN-α, are initially effective in reducing eosinophilia and symptoms in a majority of patients with platelet-derived growth factor mutation-negative HES, the development of resistance and treatment-related toxicity are common. In contrast, targeted therapy with the tyrosine kinase inhibitor, imatinib, is well tolerated but effective only in the subset of patients with HES with a primary myeloid disorder. Eosinophil-targeted biotherapeutics offer the potential of improved efficacy with few, if any, adverse effects. The aims of this review are to provide an overview of current approaches to the use of conventional HES therapies and a discussion of existing biotherapeutics that target eosinophils and their potential use in the treatment of HES. With the continuing expansion of eosinophil-targeted biotherapeutics, the future for patients with eosinophilic disorders is promising.
高嗜酸性粒细胞综合征（HES）是一组罕见疾病，其特征为外周血或组织中嗜酸性粒细胞明显增多，导致终末器官损伤。尽管包括糖皮质激素、羟基脲和 IFN-α 在内的常规治疗方法在大多数血小板衍生生长因子突变阴性 HES 患者中最初可有效降低嗜酸性粒细胞计数和症状，但耐药和治疗相关毒性的发生较为常见。相比之下，酪氨酸激酶抑制剂伊马替尼的靶向治疗具有良好的耐受性，但仅对少数伴有原发性髓系疾病的 HES 患者有效。针对嗜酸性粒细胞的生物疗法具有潜在的改善疗效而不良反应较少的优势。本文旨在概述常规 HES 治疗方法，并讨论现有的针对嗜酸性粒细胞的生物疗法及其在 HES 治疗中的潜在应用。随着针对嗜酸性粒细胞的生物疗法的不断扩展，嗜酸性粒细胞疾病患者的未来充满希望。
