Marmara University Faculty of Medicine, Division of Pediatric Allergy and Immunology, İstanbul, Turkey
İstanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, İstanbul, Turkey
Turk J Haematol. 2021 Feb 25;38(1):1-14. doi: 10.4274/tjh.galenos.2021.2020.0724. Epub 2021 Jan 14.
Primary immune regulatory disorders (PIRDs) are a group of diseases belonging to inborn errors of immunity. They usually exhibit lymphoproliferation, autoimmunities, and malignancies, with less susceptibility to recurrent infections. Unlike classical primary immune deficiencies, in autoimmune manifestations, such as cytopenias, enteropathy can be the first symptom of diseases, and they are typically resistant to treatment. Increasing awareness of PIRDs among specialists and a multidisciplinary team approach would provide early diagnosis and treatment that could prevent end-organ damage related to the diseases. In recent years, many PIRDs have been described, and understanding the immunological pathways linked to these disorders provides us an opportunity to use directed therapies for specific molecules, which usually offer better disease control than known classical immunosuppressants. In this review, in light of the most recent literature, we will discuss the common PIRDs and explain their clinical symptoms and recent treatment modalities.
原发性免疫调节紊乱(PIRDs)是一组属于先天性免疫缺陷的疾病。它们通常表现为淋巴组织增生、自身免疫和恶性肿瘤,对反复感染的敏感性较低。与经典的原发性免疫缺陷不同,在自身免疫表现中,如血细胞减少症,肠病可以是疾病的首发症状,且通常对治疗有抗性。提高专家和多学科团队对 PIRDs 的认识,可以提供早期诊断和治疗,从而预防与疾病相关的终末器官损伤。近年来,已经描述了许多 PIRDs,了解与这些疾病相关的免疫途径为我们提供了使用针对特定分子的靶向治疗的机会,这通常比已知的经典免疫抑制剂提供更好的疾病控制。在这篇综述中,我们将根据最新的文献,讨论常见的 PIRDs,并解释它们的临床症状和最近的治疗方式。