Beris P, Miescher P A
Presse Med. 1983 Nov 17;12(41):2587-91.
The aim of present-day chemotherapy treatment of chronic autoimmune diseases is to correct any disturbance in equilibrium of immune surveillance and to have a global immunosuppressive effect. Corticosteroids are the most important immunosuppressive agents. If they are administered three days out of four it is possible to preserve adrenal function. The addition of cytotoxic agents to steroids in immunosuppressive therapy allows one to preserve the immunosuppressive effect, while reducing the side effects of the steroid treatment. The use of alkylating agents must be limited because of their undoubted oncogenic effect, even though they are very effective immunosuppressive agents. Anti-lymphocyte-antithymocyte serum is a particular immunosuppressive method used primarily in autoimmune disorders associated with T lymphocyte pathology, as is cyclosporin A. Finally, plasma exchange in conjunction with immunosuppressive agents (methyl prednisolone + cyclophosphamide) administered intravenously as an intensive treatment is used only in patients with very active autoimmune disorders.
当今慢性自身免疫性疾病化疗治疗的目的是纠正免疫监视平衡中的任何紊乱，并产生全面的免疫抑制作用。皮质类固醇是最重要的免疫抑制剂。如果每四天中有三天给药，就有可能保留肾上腺功能。在免疫抑制治疗中，将细胞毒性药物添加到类固醇中可以在保留免疫抑制作用的同时，减少类固醇治疗的副作用。尽管烷化剂是非常有效的免疫抑制剂，但由于其毫无疑问的致癌作用，其使用必须受到限制。抗淋巴细胞抗胸腺细胞血清是一种特殊的免疫抑制方法，主要用于与T淋巴细胞病理相关的自身免疫性疾病，环孢素A也是如此。最后，血浆置换与静脉内给予的免疫抑制剂（甲基泼尼松龙+环磷酰胺）联合作为强化治疗，仅用于自身免疫性疾病非常活跃的患者。
