Lorenzen I
Prog Clin Biol Res. 1981;54:209-18.
The primary cause of the most common inflammatory rheumatic diseases in unknown. Microbial infection combined with an increased susceptibility due to genetically determined alterations in the immune system is probably of importance. Non-specific processes of inflammation and repair are the immediate causes of the clinical symptoms, and anti-inflammatory therapy is at present the corner stone in the control of these diseases. The highest priority in research should be given to drugs, which in controlled clinical trials have demonstrated ability to cause remission of disease activity. Important examples are D-penicillamine, glucocorticoids and the cytostatic drugs. The effects of these drugs on the metabolism of proteoglycans and collagen in granulation tissue and normal connective tissue may explain some of the beneficial effects, but also some of the side effects. Rational pharmacotherapy in the inflammatory rheumatic diseases may be a combination of anti-inflammatory drugs with immunotherapy and possibly antimicrobial therapy.
大多数常见炎性风湿性疾病的主要病因不明。微生物感染与由于免疫系统基因决定的改变而导致的易感性增加可能起重要作用。非特异性炎症和修复过程是临床症状的直接原因，目前抗炎治疗是控制这些疾病的基石。研究的最高优先事项应给予那些在对照临床试验中已证明有能力使疾病活动缓解的药物。重要的例子有青霉胺、糖皮质激素和细胞毒性药物。这些药物对肉芽组织和正常结缔组织中蛋白聚糖和胶原蛋白代谢的影响可能解释了一些有益作用，但也解释了一些副作用。炎性风湿性疾病的合理药物治疗可能是抗炎药物与免疫治疗以及可能的抗菌治疗的联合应用。
