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儿童I型干扰素病概述

Type I Interferonopathies in Children: An Overview.

作者信息

d'Angelo Debora M, Di Filippo Paola, Breda Luciana, Chiarelli Francesco

机构信息

Department of Pediatrics, University of Chieti, Chieti, Italy.

Center of Excellence on Aging, University of Chieti, Chieti, Italy.

出版信息

Front Pediatr. 2021 Mar 31;9:631329. doi: 10.3389/fped.2021.631329. eCollection 2021.

Abstract

Notable advances in gene sequencing methods in recent years have permitted enormous progress in the phenotypic and genotypic characterization of autoinflammatory syndromes. Interferonopathies are a recent group of inherited autoinflammatory diseases, characterized by a dysregulation of the interferon pathway, leading to constitutive upregulation of its activation mechanisms or downregulation of negative regulatory systems. They are clinically heterogeneous, but some peculiar clinical features may lead to suspicion: a familial "idiopathic" juvenile arthritis resistant to conventional treatments, an early necrotizing vasculitis, a non-infectious interstitial lung disease, and a panniculitis associated or not with a lipodystrophy may represent the "interferon alarm bells." The awareness of this group of diseases represents a challenge for pediatricians because, despite being rare, a differential diagnosis with the most common childhood rheumatological and immunological disorders is mandatory. Furthermore, the characterization of interferonopathy molecular pathogenetic mechanisms is allowing important steps forward in other immune dysregulation diseases, such as systemic lupus erythematosus and inflammatory myositis, implementing the opportunity of a more effective target therapy.

摘要

近年来,基因测序方法取得了显著进展,这使得自身炎症性综合征的表型和基因型特征研究取得了巨大进步。干扰素病是一组新近发现的遗传性自身炎症性疾病,其特征是干扰素通路失调,导致其激活机制持续上调或负调控系统下调。它们在临床上具有异质性,但一些特殊的临床特征可能会引起怀疑:对传统治疗有抵抗性的家族性“特发性”青少年关节炎、早期坏死性血管炎、非感染性间质性肺病,以及与脂肪营养不良相关或不相关的脂膜炎,可能代表着“干扰素警钟”。认识这组疾病对儿科医生来说是一项挑战,因为尽管它们很罕见,但与儿童最常见的风湿性和免疫性疾病进行鉴别诊断是必不可少的。此外,干扰素病分子致病机制的研究正在推动其他免疫失调疾病(如系统性红斑狼疮和炎性肌病)向前迈出重要步伐,为更有效的靶向治疗提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a498/8044321/60c3d1f8bc66/fped-09-631329-g0001.jpg

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