Schroeder Arthritis Institute, University Health Network, 60 Leonard Avenue, Toronto, ON, M5T 0S8, Canada.
Krembil Research Institute, University Health Network, Toronto, ON, Canada.
Curr Rheumatol Rep. 2022 Sep;24(9):269-278. doi: 10.1007/s11926-022-01081-7. Epub 2022 Jul 9.
Pathological roles of macrophage migration inhibitory factor (MIF) have recently been demonstrated in spondyloarthritis (SpA) preclinical models, identifying MIF as a new treatment target for SpA. However, the specific contribution of MIF and therapeutic potential of MIF-targeted therapies to various tissue types affected by SpA are not well delineated.
MIF and its cognate receptor CD74 are extensively involved in the pathogenesis of SpA including inflammation in the spine, joint, eyes, skin, and gut. The majority of the current evidence has consistently shown that MIF drives the inflammation in these distinct anatomical sites. In preclinical models, genetic deletion or blockade of MIF reduces the severity of inflammation. Although MIF is generally an upstream cytokine which regulates downstream effector cytokines, MIF also intensifies type 3 immunity by promoting helper T 17 (Th17) plasticity. MIF- or CD74-targeted therapies have also reported to be well tolerated in clinical trials for other diseases. Recent findings suggest that MIF-CD74 axis is a new therapeutic target for SpA to improve various clinical features. Clinical trials for MIF- or CD74-targeted therapies for SpA patients are warranted.
综述目的:最近在脊柱关节炎(SpA)临床前模型中证实了巨噬细胞移动抑制因子(MIF)的病理性作用,将 MIF 鉴定为 SpA 的新治疗靶点。然而,MIF 及其同源受体 CD74 对 SpA 影响的各种组织类型的具体贡献以及针对 MIF 的治疗潜力尚不清楚。
最新发现:MIF 及其同源受体 CD74 广泛参与 SpA 的发病机制,包括脊柱、关节、眼睛、皮肤和肠道的炎症。目前大多数证据一致表明,MIF 可驱动这些不同解剖部位的炎症。在临床前模型中,MIF 的基因缺失或阻断可减轻炎症的严重程度。尽管 MIF 通常是一种调节下游效应细胞因子的上游细胞因子,但它还通过促进辅助性 T 细胞 17(Th17)可塑性来增强 3 型免疫。针对其他疾病的临床试验也报告 MIF 或 CD74 靶向治疗具有良好的耐受性。最近的研究结果表明,MIF-CD74 轴是 SpA 的一个新的治疗靶点,可改善各种临床特征。针对 SpA 患者的 MIF 或 CD74 靶向治疗的临床试验是必要的。