Monteleone Giovanni, Moscardelli Alessandro, Colella Alice, Marafini Irene, Salvatori Silvia
Gastroenterology Unit, Azienda Ospedaliera Policlinico Tor Vergata, Rome, Italy; Department of Systems Medicine, University of "Tor Vergata", Rome, Italy.
Gastroenterology Unit, Azienda Ospedaliera Policlinico Tor Vergata, Rome, Italy.
Autoimmun Rev. 2023 Oct;22(10):103410. doi: 10.1016/j.autrev.2023.103410. Epub 2023 Aug 18.
The term "immune-mediated inflammatory diseases (IMIDs)" refers to several inflammatory pathologies of multifactorial etiology and involving either simultaneously or sequentially more organs. IMIDs share some common pathogenic mechanisms, which account for some similarities in the clinical course and the impact that these diseases may have on other organs and systems of the body. However, there are some differences in the IMID-associated pathological process, including the synthesis and function of multiple inflammatory cytokines, which are supposed to perpetuate the tissue-damaging inflammation. This justifies the different indications and responsiveness to corticosteroids, immunosuppressors, small molecules, and biologics. Many individuals with IMIDs are, however, intolerant, or unresponsive to the current drugs, thus suggesting the necessity of novel therapeutic approaches, such as the combination of compounds that either inhibit more immuno-inflammatory networks selectively or simultaneously suppress inflammatory signals and activate counter-regulatory pathways. In this article, we highlight the most relevant features of IMIDs and discuss how clinicians can combat the detrimental immune response in such disorders.
“免疫介导的炎症性疾病(IMIDs)”一词指的是几种病因多因素的炎症性病症,同时或相继累及多个器官。IMIDs具有一些共同的致病机制,这解释了它们在临床病程以及这些疾病可能对身体其他器官和系统产生的影响方面存在一些相似之处。然而,IMID相关的病理过程存在一些差异,包括多种炎性细胞因子的合成和功能,这些细胞因子被认为会使组织损伤性炎症持续存在。这证明了对皮质类固醇、免疫抑制剂、小分子药物和生物制剂有不同的适应症和反应性。然而,许多患有IMIDs的个体对当前药物不耐受或无反应,因此表明需要新的治疗方法,例如联合使用能够选择性抑制更多免疫炎症网络或同时抑制炎症信号并激活反调节途径的化合物。在本文中,我们强调了IMIDs的最相关特征,并讨论了临床医生如何对抗此类疾病中有害的免疫反应。