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精准医学在自身免疫性疾病治疗中的作用日益凸显;系统文献回顾和专家共识的结果。

The growing role of precision medicine for the treatment of autoimmune diseases; results of a systematic review of literature and Experts' Consensus.

机构信息

Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Unit of Allergology, Immunology and Rheumatology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

出版信息

Autoimmun Rev. 2021 Feb;20(2):102738. doi: 10.1016/j.autrev.2020.102738. Epub 2020 Dec 14.

Abstract

Autoimmune diseases (AIDs) share similar serological, clinical, and radiological findings, but, behind these common features, there are different pathogenic mechanisms, immune cells dysfunctions, and targeted organs. In this context, multiple lines of evidence suggest the application of precision medicine principles to AIDs to reduce the treatment failure. Precision medicine refers to the tailoring of therapeutic strategies to the individual characteristics of each patient, thus it could be a new approach for management of AIDS which considers individual variability in genes, environmental exposure, and lifestyle. Precision medicine would also assist physicians in choosing the right treatment, the best timing of administration, consequently trying to maximize drug efficacy, and, possibly, reducing adverse events. In this work, the growing body of evidence is summarized regarding the predictive factors for drug response in patients with AIDs, applying the precision medicine principles to provide high-quality evidence for therapeutic opportunities in improving the management of these patients.

摘要

自身免疫性疾病(AIDs)具有相似的血清学、临床和影像学表现,但在这些共同特征背后,存在着不同的发病机制、免疫细胞功能障碍和靶向器官。在这种情况下,多项证据表明将精准医学原则应用于 AIDs 以降低治疗失败率。精准医学是指根据每个患者的个体特征定制治疗策略,因此,它可能是管理 AIDS 的一种新方法,考虑到个体在基因、环境暴露和生活方式方面的差异。精准医学还将帮助医生选择正确的治疗方法,最佳的给药时机,从而最大限度地提高药物疗效,并可能减少不良反应。在这项工作中,总结了关于 AIDs 患者药物反应的预测因素的大量证据,应用精准医学原则为改善这些患者管理的治疗机会提供高质量的证据。

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