Division of Rheumatology of Guang'anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China.
Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center/Tufts University School of Medicine, Box 406, Boston, MA, 02111, USA.
Curr Rheumatol Rep. 2018 Jul 28;20(9):55. doi: 10.1007/s11926-018-0764-y.
Systemic lupus erythematosus (SLE) is a complex, potentially fatal autoimmune disease with no complete cure. Current treatments for SLE are limited by suboptimal efficacy and increased risk of infections and malignancies, and cannot meet the clinical demands of patients with SLE. Artemisinin and its derivatives (artemisinins), a new class of anti-malarial drugs, have recently been reported to have an immunosuppressive effect on lupus patients. In this review, we evaluate the therapeutic properties and potential mechanisms of artemisinins for the treatment of SLE.
Both clinical and animal studies suggest that artemisinins have potential beneficial effects for SLE. The beneficial effects associated with artemisinin treatment include improving symptoms, reducing level of antibodies and proteinuria, ameliorating renal damage, and diminishing the dosage of prednisone use. Animal studies suggest that mechanisms of action of artemisinins may include regulating T cell subsets, inhibiting activation of B cells and production of inflammatory cytokines, as well as blocking the NF-κB signal transduction pathway, thus playing a role in anti-inflammation and immunomodulation. Artemisinin family drugs are a promising potential new medication that may challenge the current treatment paradigms available for SLE.
系统性红斑狼疮(SLE)是一种复杂的、潜在致命的自身免疫性疾病,目前尚无完全治愈的方法。目前 SLE 的治疗方法疗效不理想,感染和恶性肿瘤的风险增加,无法满足 SLE 患者的临床需求。青蒿素及其衍生物(青蒿素类药物)是一类新型抗疟药物,最近有报道称其对狼疮患者具有免疫抑制作用。在这篇综述中,我们评估了青蒿素类药物治疗 SLE 的治疗特性和潜在机制。
临床和动物研究均表明青蒿素类药物对 SLE 具有潜在的有益作用。青蒿素类药物治疗的有益作用包括改善症状、降低抗体和蛋白尿水平、改善肾脏损伤以及减少泼尼松用量。动物研究表明,青蒿素类药物的作用机制可能包括调节 T 细胞亚群、抑制 B 细胞激活和炎症细胞因子的产生,以及阻断 NF-κB 信号转导通路,从而发挥抗炎和免疫调节作用。青蒿素类药物是一种很有前途的新型潜在药物,可能挑战目前 SLE 的治疗模式。