Roganović Jelena, Bellesi Gaia
Children's Hospital Zagreb, Department of Pediatric Hematology and Oncology, Zagreb, Croatia; University of Rijeka, Faculty of Biotechnology and Drug Development, Rijeka, Croatia.
University of Rijeka, Faculty of Medicine, Rijeka, Croatia.
Acta Med Acad. 2024 Dec;53(3):293-302. doi: 10.5644/ama2006-124.460.
This paper presents a comprehensive and updated overview of inborn errors of immunity (IEIs), focusing on the optimal treatment strategies. IEIs or primary immunodeficiencies (PIDs) are a heterogeneous group of approximately 500 disorders, classified into ten categories according to the affected component of the immune system. The clinical presentation varies, based on the type of the disorder and the patient's age. Early diagnosis is essential to prevent recurrent severe infections and potential organ damage. Treatment strategies, including hematopoietic stem cell transplantation, enzyme replacement therapy, thymus trans-plantation, or gene therapy, primarily focus to restore immune function. Emerging therapeutic approaches aiming to modify the immune response comprise small molecule inhibitors, biological therapies, and adoptive transfer of virus-specific T-cells. Given the complexity and diversity of PIDs, as well as evolving novel therapies, continuous education of the physicians on timely diagnosis and effective intervention, significantly improves patients' management and outcomes. CONCLUSION: Early diagnosis and individualized treatment plans are crucial for effectively managing IEIs. As treatment options evolve, ongoing education and the integration of new approaches are key to improving patient outcomes and quality of life.
本文全面且更新地概述了先天性免疫缺陷(IEIs),重点关注最佳治疗策略。先天性免疫缺陷或原发性免疫缺陷(PIDs)是一组约500种异质性疾病,根据免疫系统受影响的成分分为十类。临床表现因疾病类型和患者年龄而异。早期诊断对于预防反复严重感染和潜在器官损伤至关重要。治疗策略包括造血干细胞移植、酶替代疗法、胸腺移植或基因疗法,主要致力于恢复免疫功能。旨在调节免疫反应的新兴治疗方法包括小分子抑制剂、生物疗法以及病毒特异性T细胞的过继转移。鉴于原发性免疫缺陷的复杂性和多样性,以及不断发展的新型疗法,持续对医生进行关于及时诊断和有效干预的教育,可显著改善患者的管理和预后。结论:早期诊断和个体化治疗方案对于有效管理先天性免疫缺陷至关重要。随着治疗选择的不断发展,持续教育和新方法的整合是改善患者预后和生活质量的关键。