Arend W P
Division of Rheumatology, University of Colorado School of Medicine, Denver, USA.
Adv Intern Med. 1995;40:365-94.
In reviewing some of the mechanisms whereby cytokine effects are inhibited or blocked, this chapter has illustrated that the cytokine network is truly self-regulating. Exaggerated effects of particular cytokines in disease processes may be due to unregulated production of proinflammatory cytokines or inadequate production of anti-inflammatory cytokines. In addition, cytokine effects may be regulated at the levels of production, protein binding, receptor expression, soluble receptor generation, or receptor binding. Monoclonal antibodies to TNF-alpha, soluble receptors for IL-1 or TNF, and IL-1ra represent four promising approaches for therapeutic intervention in human diseases. As more knowledge is gained about the cytokine network in human diseases, additional avenues for treatment through inhibition of cytokine effects are certain to evolve.
在回顾一些抑制或阻断细胞因子效应的机制时,本章阐述了细胞因子网络确实是自我调节的。特定细胞因子在疾病过程中的过度效应可能是由于促炎细胞因子的产生不受调控或抗炎细胞因子的产生不足。此外,细胞因子效应可在产生、蛋白质结合、受体表达、可溶性受体生成或受体结合水平上受到调节。抗TNF-α单克隆抗体、IL-1或TNF的可溶性受体以及IL-1ra代表了人类疾病治疗干预的四种有前景的方法。随着对人类疾病中细胞因子网络的了解越来越多,可以肯定的是,通过抑制细胞因子效应进行治疗的其他途径将会不断涌现。