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类风湿关节炎相关间质性肺疾病中的共享免疫途径。

Shared immunological pathways in rheumatoid arthritis-related interstitial lung disease.

作者信息

Xu Jingyi, Li Changhong, Zhao Jinxia, Mu Rong

机构信息

Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.

出版信息

Front Immunol. 2025 Oct 1;16:1630729. doi: 10.3389/fimmu.2025.1630729. eCollection 2025.

Abstract

Interstitial lung disease (ILD) is a significant extra-articular complication of rheumatoid arthritis (RA), characterized by high prevalence and mortality rates. Although advancements have been made in understanding its potential mechanisms, the pathogenesis of RA-associated ILD remains incompletely understood. Recent research has shed light on roles of various disease-related signaling pathways, including TGF-β/SMAD, JAK/STAT, PI3K-Akt, Wnt/β-catenin, and NF-κB, which are implicated in development of both RA and lung fibrosis. These shared pathways, which drive inflammatory cytokine production and fibroblast proliferation, offer promising opportunities for therapeutic intervention, including pathway-specific inhibition and drug repurposing. Furthermore, the growing identification of potential biomarkers for early detection and severity assessment in RA-ILD patients holds promise for improving clinical management and guiding treatment strategies. Current treatments fall short in effectively halting the progression of lung fibrosis. This highlights the potential of advancements in signaling pathways and targeted therapies as promising alternatives with significant opportunities for improvement.

摘要

间质性肺病(ILD)是类风湿关节炎(RA)一种重要的关节外并发症,其特点是患病率和死亡率都很高。尽管在了解其潜在机制方面已取得进展,但RA相关ILD的发病机制仍未完全明确。最近的研究揭示了各种疾病相关信号通路的作用,包括转化生长因子-β/信号转导和转录激活因子(TGF-β/SMAD)、Janus激酶/信号转导和转录激活因子(JAK/STAT)、磷脂酰肌醇-3激酶-蛋白激酶B(PI3K-Akt)、Wnt/β-连环蛋白以及核因子-κB(NF-κB),这些信号通路与RA和肺纤维化的发展都有关联。这些共同的信号通路可驱动炎性细胞因子的产生和成纤维细胞的增殖,为治疗干预提供了有前景的机会,包括通路特异性抑制和药物重新利用。此外,越来越多可用于早期检测和评估RA-ILD患者病情严重程度的潜在生物标志物被发现,这有望改善临床管理并指导治疗策略。目前的治疗方法在有效阻止肺纤维化进展方面存在不足。这凸显了信号通路进展和靶向治疗作为有前景的替代方案的潜力,有很大的改进空间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db62/12521453/6de0fc85da78/fimmu-16-1630729-g001.jpg

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