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抗白细胞介素-5疗法在嗜酸性筋膜炎中是否有作用?

Is there a Role for Anti-IL-5 Therapies in Eosinophilic Fasciitis?

作者信息

Angelopoulos Andreas, Kouverianos Ioannis, Daoussis Dimitrios

机构信息

Internal Medicine Resident, General Hospital of East Achaia, Kalavryta, Greece.

Medical Graduate, University of Patras Medical School, Patras, Greece.

出版信息

Mediterr J Rheumatol. 2023 Dec 30;34(4):414-417. doi: 10.31138/mjr.301223.itr. eCollection 2023 Dec.

Abstract

INTRODUCTION

Eosinophilic Fasciitis (EF) is a rare disease, originally proposed as "diffuse fasciitis with eosinophilia" by Shulman in 1974. Symptoms of EF include peripheral eosinophilia accompanied by symmetrical inflammation of the subcutaneous fascia and muscle, usually locating in the upper arms or thighs. There is no approved standard of care treatment.

METHODS

Taking into account that eosinophils may be pathogenetically involved in EF, we performed a review on Medline focusing on anti-Interleukin-5 (IL-5) therapies in EF.

RESULTS

Only one case of a patient with EF has been reported who was successfully treated with reslizumab, an anti-IL-5 therapy. The patient had EF refractory to the commonly used immunosuppressive treatment but when reslizumab was added, the patient experienced remission of her symptoms.

DISCUSSION

The exact aetiology of EF is still unclear, and many therapeutic approaches have been tested. Commonly used immunosuppressive agents, such as corticosteroids are not always effective and associate with significant side effects. Eosinophils seem to have a role in the pathogenesis of the disease; anti-eosinophilic therapies targeting IL-5/IL-5 Receptor could be an attractive alternative for the treatment of the disease.

摘要

引言

嗜酸性筋膜炎(EF)是一种罕见疾病,最初由舒尔曼于1974年提出为“伴有嗜酸性粒细胞增多的弥漫性筋膜炎”。EF的症状包括外周嗜酸性粒细胞增多,伴有皮下筋膜和肌肉的对称性炎症,通常位于上臂或大腿。目前尚无获批的标准治疗方案。

方法

考虑到嗜酸性粒细胞可能在EF的发病机制中起作用,我们在医学在线数据库(Medline)上进行了一项综述,重点关注EF中抗白细胞介素-5(IL-5)疗法。

结果

仅报告了1例EF患者,其接受抗IL-5疗法瑞利珠单抗治疗成功。该患者对常用的免疫抑制治疗无效,但添加瑞利珠单抗后症状缓解。

讨论

EF的确切病因仍不清楚,且已对多种治疗方法进行了测试。常用的免疫抑制剂,如皮质类固醇并不总是有效,且伴有显著的副作用。嗜酸性粒细胞似乎在该疾病的发病机制中起作用;针对IL-5/IL-5受体的抗嗜酸性粒细胞疗法可能是治疗该疾病的一种有吸引力的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45a/10815516/c9b53493a2cd/MJR-34-4-414-g001.jpg

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