Cheng Lianying, Rong Xiaofeng
Department of Integrated Traditional Chinese and Western Medicine,The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Department of Integrated Traditional Chinese and Western Medicine,The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Transpl Immunol. 2025 Mar;89:102187. doi: 10.1016/j.trim.2025.102187. Epub 2025 Jan 30.
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder primarily distinguished by synovial inflammation, which, as the disease evolves, can lead to bone erosion and destruction. Consequently, the pivotal strategy in preventing joint damage and fostering functional recovery lies in the effective management of synovial inflammation. Disease-modifying antirheumatic drugs (DMARDs) and prednisone therapy remain the first-line treatments for RA. However, in instances of refractory RA, these medications may fall short in adequately controlling inflammation, and they are often accompanied by several adverse effects, including limited bioavailability, therapeutic resistance, and potentially toxic side effects. Given these challenges, the identification of targeted therapies to manage disease activity and diminish inflammation becomes imperative.Recently, biologic agents for the treatment of RA have garnered significant attention owing to their minimal side effect profile, reduced potential for drug dependence, and their precise therapeutic action directly on target cells. This review provides a comprehensive exploration of advancements in biologics that target and inhibit inflammatory cytokine receptors, specifically TNF-α, IL-6, and IL-1β, as well as B lymphocyte receptors, TLR4, nanodrugs, and Janus kinase (JAK) inhibitors in the context of RA. By providing innovative perspectives and strategies for the treatment of this condition, this review contributes to the ongoing efforts to refine and improve the therapeutic landscape for RA.
类风湿性关节炎（RA）是一种慢性全身性自身免疫性疾病，主要特征为滑膜炎症，随着疾病发展，可导致骨侵蚀和破坏。因此，预防关节损伤和促进功能恢复的关键策略在于有效控制滑膜炎症。改善病情抗风湿药（DMARDs）和泼尼松治疗仍然是RA的一线治疗方法。然而，在难治性RA的情况下，这些药物可能无法充分控制炎症，并且它们通常伴有多种不良反应，包括生物利用度有限、治疗抵抗以及潜在的毒副作用。鉴于这些挑战，确定针对性疗法来控制疾病活动和减轻炎症变得势在必行。最近，用于治疗RA的生物制剂因其副作用极小、药物依赖可能性降低以及对靶细胞具有精确的治疗作用而备受关注。本综述全面探讨了在RA背景下，针对并抑制炎性细胞因子受体（特别是TNF-α、IL-6和IL-1β）以及B淋巴细胞受体、TLR4、纳米药物和Janus激酶（JAK）抑制剂的生物制剂的进展。通过为这种疾病的治疗提供创新观点和策略，本综述有助于不断完善和改善RA的治疗前景。
