Biological treatments in Behçet's disease: beyond anti-TNF therapy.
Biological treatments in Behçet's disease: beyond anti-TNF therapy.
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DOI：
10.1155/2014/107421
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发表时间：
2014
影响因子：
4.6
通讯作者：
Cantarini L
中科院分区：
文献类型：
--
作者：
Caso F;Costa L;Rigante D;Lucherini OM;Caso P;Bascherini V;Frediani B;Cimaz R;Marrani E;Nieves-Martín L;Atteno M;Raffaele CG;Tarantino G;Galeazzi M;Punzi L;Cantarini L
BEHçet‘s病(BEHçet’s disease，BD)是公认的一种病因不明的多系统炎症性疾病，其慢性病程和不可预测的恶化：其临床表现从单纯的脉管炎伴血栓并发症到多器官和组织的变化性炎症累及。随着对BD发病机制的深入了解，BD的治疗发生了革命性的变化，涉及多种致炎分子的功能障碍和过度分泌，主要是肿瘤坏死因子-α、白介素1-β和白介素6。然而，尽管抗肿瘤坏死因子-α制剂的生物治疗在很大程度上被证明对BD有效，但并不是所有的患者都是明确的反应者，这种有益的反应可能会随着时间的推移而下降。因此，不可避免地需要对难治性BD患者进行额外的治疗。针对不同细胞因子及其受体或细胞表面分子的不同药物已被研究：IL-1受体被anakinra靶向，IL-1被canakinumab和gevokizumab靶向，IL-6受体被tocilizumab靶向，IL12/23受体被ustekinumab靶向，B淋巴细胞抗原CD-20被利妥昔单抗靶向。该综述的目的是总结所有目前的经验和最新的证据，这些新的方法与生物药物以外的肿瘤坏死因子-α阻滞剂治疗BD，提供了一个有价值的补充实际可用的治疗性医疗设备。
Behçet's disease (BD) is universally recognized as a multisystemic inflammatory disease of unknown etiology with chronic course and unpredictable exacerbations: its clinical spectrum varies from pure vasculitic manifestations with thrombotic complications to protean inflammatory involvement of multiple organs and tissues. Treatment has been revolutionized by the progressed knowledge in the pathogenetic mechanisms of BD, involving dysfunction and oversecretion of multiple proinflammatory molecules, chiefly tumor necrosis factor- (TNF-) α, interleukin- (IL-) 1β, and IL-6. However, although biological treatment with anti-TNF-α agents has been largely demonstrated to be effective in BD, not all patients are definite responders, and this beneficial response might drop off over time. Therefore, additional therapies for a subset of refractory patients with BD are inevitably needed. Different agents targeting various cytokines and their receptors or cell surface molecules have been studied: the IL-1 receptor has been targeted by anakinra, the IL-1 by canakinumab and gevokizumab, the IL-6 receptor by tocilizumab, the IL12/23 receptor by ustekinumab, and the B-lymphocyte antigen CD-20 by rituximab. The aim of this review is to summarize all current experiences and the most recent evidence regarding these novel approaches with biological drugs other than TNF-α blockers in BD, providing a valuable addition to the actually available therapeutic armamentarium.
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作者：
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