Department of Rheumatology and Clinical Immunology, University Medical Centre Groningen, Groningen, Netherlands
Department of Rheumatology and Clinical Immunology, University Medical Centre Groningen, Groningen, Netherlands.
RMD Open. 2022 Feb;8(1). doi: 10.1136/rmdopen-2021-001652.
Despite the heterogeneity of the giant cell arteritis (GCA) at the level of clinical manifestations and the cellular and molecular players involved in its pathogenesis, GCA is still treated with standardised regimens largely based on glucocorticoids (GC). Long-term use of high dosages of GC as required in GCA are associated with many clinically relevant side effects. In the recent years, the interleukin-6 receptor blocker tocilizumab has become available as the only registered targeted immunosuppressive agent in GCA. However, immunological heterogeneity may require different pathways to be targeted in order to achieve a clinical, immunological and vascular remission in GCA. The advances in the targeted blockade of various molecular pathways involved in other inflammatory and autoimmune diseases have catalyzed the research on targeted therapy in GCA. This article gives an overview of the studies with targeted immunosuppressive treatments in GCA, with a focus on their clinical value, including their effects at the level of vascular inflammation.
尽管巨细胞动脉炎 (GCA) 在临床表现和参与其发病机制的细胞和分子方面存在异质性，但 GCA 的治疗仍然采用基于糖皮质激素 (GC) 的标准化方案。GCA 所需的长期大剂量 GC 治疗与许多临床相关的副作用有关。近年来，白细胞介素 6 受体阻滞剂托珠单抗已成为 GCA 中唯一注册的靶向免疫抑制剂。然而，免疫异质性可能需要针对不同的途径，以实现 GCA 的临床、免疫和血管缓解。靶向阻断其他炎症和自身免疫性疾病中涉及的各种分子途径的进展推动了 GCA 中靶向治疗的研究。本文概述了 GCA 中靶向免疫抑制治疗的研究，重点介绍了它们的临床价值，包括它们在血管炎症方面的作用。
