Breedveld F C, van der Lubbe P A
Department of Rheumatology, University Hospital, Leiden, The Netherlands.
Br Med Bull. 1995 Apr;51(2):493-502. doi: 10.1093/oxfordjournals.bmb.a072975.
The recognition that certain monoclonal antibodies have immunosuppressive properties led to the therapeutic application in autoimmune rheumatic diseases, rheumatoid arthritis in particular. The therapeutic potential of monoclonal antibodies directed against cell surface antigens mainly present on T-cells has been suggested by open trials in rheumatoid arthritis but the results of controlled studies are disappointing. Open intervention studies with monoclonal antibodies directed at other antigens relevant for the rheumatoid inflammation such as the intercellular adhesion molecule ICAM-1 or the cytokines IL-6 and TNF alpha provided encouraging clinical improvements. The impressive potential of anti-TNF alpha which was already illustrated by the immediate suppression of the acute phase response in open studies could be confirmed by a recently completed controlled trial. The present overview summarizes the available information on the results of these treatment modalities and discusses the possibilities of monoclonal antibodies as a long term treatment for rheumatic diseases.
认识到某些单克隆抗体具有免疫抑制特性后，其开始应用于自身免疫性风湿疾病的治疗，尤其是类风湿关节炎。针对主要存在于T细胞上的细胞表面抗原的单克隆抗体的治疗潜力，已在类风湿关节炎的开放性试验中得到提示，但对照研究的结果却令人失望。针对与类风湿炎症相关的其他抗原（如细胞间粘附分子ICAM - 1或细胞因子IL - 6和TNFα）的单克隆抗体的开放性干预研究，带来了令人鼓舞的临床改善。抗TNFα在开放性研究中对急性期反应的立即抑制所显示出的巨大潜力，已被最近完成的一项对照试验所证实。本综述总结了这些治疗方式结果的现有信息，并讨论了单克隆抗体作为风湿疾病长期治疗方法的可能性。
