Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, APHP-Centre Université de Paris (CUP), Paris, France.
Université de Paris, Institut Imagine, INSERMU1163, Laboratory of Immunogenetics of Pediatric Autoimmuninity, Paris, France.
Front Immunol. 2021 Sep 17;12:717388. doi: 10.3389/fimmu.2021.717388. eCollection 2021.
Among inborn errors of immunity (IEIs), some conditions are characterized by inflammation and autoimmunity at the front line and are particularly challenging to treat. Monogenic diseases associated with gain-of-function mutations in genes critical for cytokine signaling through the JAK-STAT pathway belong to this group. These conditions represent good candidates for treatment with JAK inhibitors. Type I interferonopathies, a group of recently identified monogenic auto-inflammatory diseases characterized by excessive secretion of type I IFN, are also good candidates with growing experiences reported in the literature. However, many questions remain regarding the choice of the drug, the dose (in particular in children), the efficacy on the various manifestations, the monitoring of the treatment, and the management of potent side effects in particular in patients with infectious susceptibility. This review will summarize the current experiences reported and will highlight the unmet needs.
在先天性免疫缺陷(IEI)中,有些病症的特点是一线炎症和自身免疫,治疗极具挑战性。此类病症与 JAK-STAT 通路中细胞因子信号关键基因的功能获得性突变相关的单基因疾病属于这一组。这些病症是 JAK 抑制剂治疗的良好候选。I 型干扰素病是一组最近确定的单基因自身炎症性疾病,其特征是 I 型 IFN 的过度分泌,也有大量文献报道具有良好的治疗效果,因此也是良好的候选病症。然而,在药物选择、剂量(尤其是儿童)、对各种表现的疗效、治疗监测以及特别在易感染患者中处理潜在严重副作用方面,仍存在许多问题。这篇综述将总结目前报道的经验,并强调未满足的需求。