The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Best Pract Res Clin Rheumatol. 2022 Dec;36(4):101814. doi: 10.1016/j.berh.2022.101814. Epub 2023 Jan 24.
Systemic lupus erythematosus (SLE) is a typical autoimmune disease that leads to multiple organ damage. For over half a century, SLE has been treated mainly with nonspecific glucocorticoids and immunosuppressants, and the development of molecular target drugs with few adverse reactions is awaited. The treatment goal is remission without systemic symptoms or organ damage. An anti-B-cell activating factor antibody belimumab and an anti-type I interferon receptor antibody anifrolumab are used for patients with active SLE who respond poorly to standard of cares. Additionally, as many susceptibility genes for SLE are associated with signal transduction of dendritic and B cells, cytokines and signaling molecules that bridge the innate and adaptive immune systems are the current focus of attention. Promising approaches include the development of a Janus kinase inhibitors targeting tyrosine kinase deucravacitinib, plasmacytoid dendritic cell-targeted drugs, proteasome inhibitors (e.g., iberdomide), type II anti-CD20 antibody, and obinutuzumab.
系统性红斑狼疮(SLE)是一种典型的自身免疫性疾病,可导致多器官损伤。半个多世纪以来,SLE 的治疗主要采用非特异性糖皮质激素和免疫抑制剂,期待开发不良反应少的分子靶向药物。治疗目标是无全身症状或器官损伤的缓解。对于对标准治疗反应不佳的活动期 SLE 患者,使用抗 B 细胞激活因子抗体贝利尤单抗和抗 I 型干扰素受体抗体阿尼鲁单抗。此外,由于 SLE 的许多易感基因与树突状细胞和 B 细胞的信号转导有关,因此连接固有免疫和适应性免疫系统的细胞因子和信号分子是当前关注的焦点。有前途的方法包括开发针对酪氨酸激酶的 Janus 激酶抑制剂、靶向浆细胞样树突状细胞的药物、蛋白酶体抑制剂(如伊布替尼)、II 型抗 CD20 抗体和奥滨尤妥珠单抗。