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成人免疫性血小板减少症治疗的最新进展

Recent advances in treatments of adult immune thrombocytopenia.

作者信息

Kim Dae Sik

机构信息

Division of Hematology-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.

出版信息

Blood Res. 2022 Apr 30;57(S1):112-119. doi: 10.5045/br.2022.2022038.

Abstract

Immune thrombocytopenia (ITP) is isolated thrombocytopenia characterized by autoimmune-mediated disruption of platelet without other etiologies. Treatments for chronic ITP consist of corticosteroids, intravenous immunoglobulins, anti-D immunoglobulin, rituximab, thrombopoietin receptor agonists, immunosuppressants and splenectomy. Although current therapies are effective in over two-thirds of patients, some patients are refractory to therapies or fail to achieve long-term responses. Recently, great advance has been made in identifying various mechanisms involved in ITP pathogenesis, and new treatments targeting these pathways are being developed. Novel agents such as splenic tyrosine kinase inhibitor, Bruton kinase inhibitor, plasma cell targeting therapies, neonatal Fc receptor inhibitor, platelet desialylation inhibitor, and inhibition of the classical complement pathway are expected to be effective for ITP treatment. This review summarizes current strategies and emerging therapies of ITP.

摘要

免疫性血小板减少症(ITP)是一种孤立性血小板减少症,其特征是自身免疫介导的血小板破坏,无其他病因。慢性ITP的治疗方法包括皮质类固醇、静脉注射免疫球蛋白、抗D免疫球蛋白、利妥昔单抗、血小板生成素受体激动剂、免疫抑制剂和脾切除术。尽管目前的治疗方法对超过三分之二的患者有效,但一些患者对治疗无效或无法实现长期缓解。最近,在确定ITP发病机制中涉及的各种机制方面取得了重大进展,并且正在开发针对这些途径的新治疗方法。新型药物如脾酪氨酸激酶抑制剂、布鲁顿激酶抑制剂、浆细胞靶向疗法、新生儿Fc受体抑制剂、血小板去唾液酸化抑制剂以及经典补体途径的抑制有望对ITP治疗有效。本综述总结了ITP的当前策略和新兴疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b85e/9057657/b9d6280ea840/br-57-s1-s112-f1.jpg

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