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免疫缺陷患者的治疗:药物治疗、基因治疗和移植。

Treatment of patients with immunodeficiency: Medication, gene therapy, and transplantation.

作者信息

Segundo Gesmar Rodrigues Silva, Condino-Neto Antonio

机构信息

Universidade Federal de Uberlândia, Departamento de Pediatra, Uberlândia, MG, Brazil.

Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Imunologia, São Paulo, SP, Brazil.

出版信息

J Pediatr (Rio J). 2021 Mar-Apr;97 Suppl 1(Suppl 1):S17-S23. doi: 10.1016/j.jped.2020.10.005. Epub 2020 Nov 9.

Abstract

OBJECTIVES

To provide an overview of drug treatment, transplantation, and gene therapy for patients with primary immunodeficiencies.

SOURCE OF DATA

Non-systematic review of the literature in the English language carried out at PubMed.

SYNTHESIS OF DATA

The treatment of patients with primary immunodeficiencies aims to control their disease, especially the treatment and prevention of infections through antibiotic prophylaxis and/or immunoglobulin replacement therapy. In several diseases, it is possible to use specific medications for the affected pathway with control of the condition, especially in autoimmune or autoinflammatory processes associated with inborn immunity errors. In some diseases, treatment can be curative through hematopoietic stem cell transplantation (HSCT); more recently, gene therapy has opened new horizons through new technologies.

CONCLUSIONS

Immunoglobulin replacement therapy remains the main therapeutic tool. Precision medicine with specific drugs for altered immune pathways is already a reality for several immune defects. Advances in the management of HSCT and gene therapy have expanded the capacity for curative treatments in patients with primary immunodeficiencies.

摘要

目的

概述原发性免疫缺陷患者的药物治疗、移植治疗和基因治疗。

数据来源

在PubMed上对英文文献进行的非系统性综述。

数据综合

原发性免疫缺陷患者的治疗旨在控制其疾病,特别是通过抗生素预防和/或免疫球蛋白替代疗法来治疗和预防感染。在几种疾病中,可以使用针对受影响通路的特定药物来控制病情,特别是在与先天性免疫缺陷相关的自身免疫或自身炎症过程中。在某些疾病中,造血干细胞移植(HSCT)可实现治愈;最近,基因治疗通过新技术开辟了新的前景。

结论

免疫球蛋白替代疗法仍然是主要的治疗手段。针对免疫通路改变使用特定药物的精准医学对于几种免疫缺陷来说已经成为现实。HSCT和基因治疗管理方面的进展扩大了原发性免疫缺陷患者的治愈性治疗能力。

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