Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 JieFang Road, Wuhan, HuBei, China.
Department of Nephrology and Rheumatology, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Clin Rheumatol. 2021 Apr;40(4):1211-1220. doi: 10.1007/s10067-020-05320-z. Epub 2020 Aug 13.
Interstitial lung disease (ILD) accounts for the major cause of morbidity and mortality in rheumatoid arthritis (RA). However, little is known of the pathogenesis, diagnosis and treatment of RA-associated ILD. In this review, we describe our present understanding and ongoing research in RA-ILD. Its aetiology does appear to associate with anti-cyclic citrullinated peptide antibodies, MUC5B mutation and smoking. Another focus of this article is on recent diagnostic methods in RA-ILD. Compared with other methods, high-resolution computed tomography (HRCT) imaging is a main method for the evaluation of ILD in RA patients. Pulmonary function is better suited for assessing progression. An important topic relates to therapeutic intervention. Disease-modifying anti-rheumatic drugs (DMARDs) in RA lack strong evidence in the onset or worsening of ILD. The available literature support that methotrexate, leflunomide, abatacept and rituximab play beneficial roles in the prevention and treatment of RA-ILD.
间质性肺疾病（ILD）是类风湿关节炎（RA）患者发病率和死亡率的主要原因。然而，人们对 RA 相关 ILD 的发病机制、诊断和治疗知之甚少。在这篇综述中，我们描述了我们对 RA-ILD 的现有认识和正在进行的研究。其病因似乎与抗环瓜氨酸肽抗体、MUC5B 突变和吸烟有关。本文的另一个重点是最近 RA-ILD 的诊断方法。与其他方法相比，高分辨率计算机断层扫描（HRCT）成像更适合评估 RA 患者的 ILD。肺功能更适合评估进展情况。一个重要的话题涉及治疗干预。在 RA 中，改变病情的抗风湿药物（DMARDs）在ILD 的发病或恶化方面缺乏强有力的证据。现有文献支持甲氨蝶呤、来氟米特、阿巴西普和利妥昔单抗在预防和治疗 RA-ILD 中发挥有益作用。
