Interferon-alpha: a therapeutic target in systemic lupus erythematosus.

Interferon-alpha: a therapeutic target in systemic lupus erythematosus.
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干扰素-α:系统性红斑狼疮的治疗靶点。

DOI:
10.1016/j.rdc.2009.12.008
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发表时间:
2010-02
影响因子:
2.3
通讯作者:
Crow, Mary K.
Crow, Mary K.
中科院分区:
医学4区
文献类型:
--
作者:
Crow, Mary K.

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在过去的十年中,SLE患者IFNα升高与疾病活动性相关的长期历史具有高度意义,积累的数据强烈支持狼疮患者细胞中I型IFN途径的广泛激活,IFN途径激活与SLE的显著临床表现相关,以及基于经验证的措施的疾病活动性增加。此外,IFN途径激活与RNA结合蛋白特异性自身抗体的存在的令人信服的关联有助于描绘TLR激活的重要作用,通过含RNA的免疫复合物在放大先天免疫系统激活和IFN途径激活。虽然SLE和IFN途径的主要触发因素尚未确定,但狼疮遗传学的快速进展有助于确定狼疮相关的遗传变异,其与狼疮患者的IFN产生或反应具有功能关系。总之,与SLE中IFN途径相关的数据和理解的爆炸已经为狼疮社区将这些见解转化为改善患者护理做好了准备。将需要耐心,以允许在多个临床中心收集所需的临床数据和生物标本,这将支持所需的IFN活性、IFN诱导基因表达或靶向趋化因子基因产物作为候选生物标志物的检测。同时,有希望的临床试验正在向前推进,以测试IFNα单克隆抗体抑制剂的安全性和有效性。其他靶向IFN途径的治疗方法可能紧随其后。
The long history of elevated IFNα in association with disease activity in patients with SLE has taken on high significance in the past decade with accumulating data strongly supporting broad activation of the type I IFN pathway in cells of lupus patients, association of IFN pathway activation with significant clinical manifestations of SLE, and increased disease activity based on validated measures. In addition, a convincing association of IFN pathway activation with the presence of autoantibodies specific for RNA-binding proteins has contributed to delineation of an important role for TLR activation by RNA-containing immune complexes in amplifying innate immune system activation and IFN pathway activation. While the primary triggers of SLE and the IFN pathway remain undefined, rapid progress in lupus genetics is helping to define lupus – associated genetic variants with a functional relationship to IFN production or response in lupus patients. Together, the explosion of data and understanding related to the IFN pathway in SLE have readied the lupus community for translation of those insights to improved patient care. Patience will be needed to allow the required collection of clinical data and biologic specimens across multiple clinical centers that will support the required testing of IFN activity, IFN-inducible gene expression or target chemokine gene products as candidate biomarkers. Meanwhile, promising clinical trials are moving forward to test the safety and efficacy of monoclonal antibody inhibitors of IFNα. Other therapeutic approaches to target the IFN pathway may follow close behind.
干扰素诱导趋化因子转录水平升高与系统性红斑狼疮患者疾病活动和器官损伤的关联。
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