Biomolecular cytokine therapy
Biomolecular cytokine therapy
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DOI：
10.1007/bf03033710
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发表时间：
2003-01-01
影响因子：
2.8
通讯作者：
Borvendég, J
中科院分区：
文献类型：
--
作者：
Bencsáth, M;Blaskovits, A;Borvendég, J
至于炎症免疫性疾病的慢性性，它们的药物治疗需要是长期的，因此，由于药物作用的副作用，相当安全。这些疾病的治疗包括类固醇和非类固醇抗炎药单药治疗或与细胞毒性抗代谢药联合治疗。长期服用这些活性物质会累积副作用，更不用说对使用中的药物产生无反应的可能性了。原则上，干预越早，药物治疗的效果越好。与这一原则相一致，生物药理学侧重于炎症免疫性疾病早期（急性）阶段的特定靶标。这些靶点之一是细胞因子（IL1 β、IL6、IL8、IL12、TNF α）的促炎级联反应。其中，肿瘤坏死因子（TNF α）的过度产生被认为是疾病表型的协调和升级。因此，靶向TNF α可以限制或阻止病理反应的传播。过量的TNF α可以在转录、翻译、分泌水平以及以细胞外可溶形式被捕获。后一种方法得到了强调使用重组抗体和可溶性受体捕获过量TNF α的临床记录的支持。本文综述了英夫利西单抗（抗体）和依那西普（可溶性受体）在类风湿关节炎（RA）中的疗效和安全性。
As for the chronicity of inflammatory-immune diseases, the medication of them needs to be longterm and thus, quite safe with respect to side effects due to drug actions. Therapy of these diseases includes steroid and non steroid anti-inflammatories given in monotherapy or in combination with cytotoxic antimetabolites. Longterm administration of these active substances cumulate in side effects, not to speak of the probability of developing unresponsiveness to the drug in use. In principle, the earlier the intervention, the better the outcome of medication in therapy. In harmony with this principle, biopharmacology focuses on specific targets in early (acute) phase of inflammatory-immune diseases. One of these targets is the proinflammatory cascade of cytokines (IL1beta, IL6, IL8, IL12, TNFalpha). Among them, the overproduction of tumor necrosis factor (TNFalpha) is suggested to orchestrate and escalate the disease phenotype. Hence, targeting of TNFalpha may restrict or stop the propagation of pathological reactions. TNFalpha in its excess can be captured at transcription, translation, secretion levels as well as in the extracellular soluble form. This latter approach is supported by clinical records emphasizing the use of recombinant antibodies and soluble receptors in trapping extra amounts of TNFalpha. This review serves as an illustration for the efficacy and safety of infliximab (antibody) and etanercept (soluble receptor) in the example of rheumatoid arthritis (RA).