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系统性红斑狼疮的免疫发病机制与治疗。

Immunological pathogenesis and treatment of systemic lupus erythematosus.

机构信息

Department of Pediatric Rheumatology and Allergy, The First Hospital, Jilin University, Changchun, China.

Department of Allergy Immunology and Rheumatology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

World J Pediatr. 2020 Feb;16(1):19-30. doi: 10.1007/s12519-019-00229-3. Epub 2019 Feb 22.

Abstract

BACKGROUND

Systemic lupus erythematosis (SLE) is a complex and clinically heterogeneous autoimmune disease. A variety of immunological defects contribute to SLE, including dysregulated innate and adaptive immune response. A clearer understanding of the mechanisms driving disease pathogenesis combined with recent advances in medical science is predicted to enable accelerated progress towards improved SLE-personalized approaches to treatment. The aim of this review was to clarify the immunological pathogenesis and treatment of SLE.

DATA SOURCES

Literature reviews and original research articles were collected from database, including PubMed and Wanfang. Relevant articles about SLE were included.

RESULTS

Breakdown of self-tolerance is the main pathogenesis of SLE. The innate and adaptive immune networks are interlinked with each other through cytokines, complements, immune complexes and kinases of the intracellular machinery. Treatments targeted at possible targets of immunity have been assessed in clinical trials. Most of them did not show better safety and efficacy than traditional treatments. However, novel targeting treatments are still being explored.

CONCLUSIONS

Dysregulated immune response plays a critical role in SLE, including innate immunity and adaptive immunity. Biologic agents that aim to specifically target abnormal immune processes were assessing and may bring new hope to SLE patients.

摘要

背景

系统性红斑狼疮(SLE)是一种复杂且临床表现多样的自身免疫性疾病。多种免疫学缺陷导致 SLE 的发生,包括先天和适应性免疫反应失调。对驱动疾病发病机制的机制的更清晰理解,结合医学科学的最新进展,预计将能够加速实现改善 SLE 个体化治疗方法的进展。本综述旨在阐明 SLE 的免疫学发病机制和治疗方法。

资料来源

从包括 PubMed 和万方在内的数据库中收集了文献综述和原始研究文章。纳入了关于 SLE 的相关文章。

结果

自身耐受的破坏是 SLE 的主要发病机制。先天和适应性免疫网络通过细胞因子、补体、免疫复合物和细胞内机制的激酶相互联系。针对可能的免疫靶点的治疗方法已在临床试验中进行评估。它们中的大多数并不比传统治疗更安全有效。然而,新的靶向治疗仍在探索中。

结论

失调的免疫反应在 SLE 中起着关键作用,包括先天免疫和适应性免疫。旨在针对异常免疫过程的生物制剂正在评估中,可能为 SLE 患者带来新的希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3dd/7040062/814013dec109/12519_2019_229_Fig1_HTML.jpg

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