Tumour necrosis factor-α inhibition can stabilize disease in progressive vitiligo.
Tumour necrosis factor-α inhibition can stabilize disease in progressive vitiligo.
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DOI：
10.1111/bjd.14016
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Le Poole IC
中科院分区：
文献类型：
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作者：
Webb KC;Tung R;Winterfield LS;Gottlieb AB;Eby JM;Henning SW;Le Poole IC
肿瘤坏死因子（TNF） - α是许多自身免疫性疾病的促进性细胞因子，在白化中已经实施了许多自身免疫性疾病。进行性白癜风的患者，但这是矛盾的是，在某些患者中，治疗可能与其他自身免疫性条件相关，尤其是在使用Adalimumumb和英夫利昔单抗时，这些研究会增强了陈述适当结果的重要性，因为大多数先导试验都可以衡量的是降级的临时。 ，，，，如果TNF-α抑制能够取消细胞毒性的T细胞介导的黑素细胞破坏，那么对从头疾病的持续关注可能会阻止更广泛地应用TNF抑制剂来治疗紫癜。
这个主题已经知道什么？
在活性白癜风病变中存在肿瘤坏死因子（TNF）-α的水平升高。
在白癜风中TNF-α抑制时，抗TNF-α剂已被标记为无效，因为没有实现抑制。
这项研究增加了什么？
在患有进行性疾病的患者中，TNF-α抑制作用可以提供一种停止白癜风部署的手段。
Tumour necrosis factor (TNF)‐α, a proinflammatory cytokine central to many autoimmune diseases, has been implicated in the depigmentation process in vitiligo. We review its role in vitiligo by exploring its pro‐ and anti‐inflammatory properties and examine the effects of blocking its actions with TNF‐α antagonist therapeutics in reports available in the literature. We found that TNF‐α inhibition halts disease progression in patients with progressive vitiligo but that, paradoxically, treatment can be associated with de novo vitiligo development in some patients when used for other autoimmune conditions, particularly when using adalimumab and infliximab. These studies reinforce the importance of stating appropriate outcomes measures, as most pilot trials propose to measure repigmentation, whereas halting depigmentation is commonly overlooked as a measure of success. We conclude that TNF‐α inhibition has proven useful for patients with progressive vitiligo, where TNF‐α inhibition is able to quash cytotoxic T‐cell‐mediated melanocyte destruction. However, a lingering concern for initiating de novo disease will likely prevent more widespread application of TNF inhibitors to treat vitiligo. What's already known about this topic? Increased levels of tumour necrosis factor (TNF)‐α are present in active vitiligo lesions. Upon TNF‐α inhibition in vitiligo, anti‐TNF‐α agents have been labelled as ineffective, as repigmentation was not achieved. What does this study add? In patients with progressive disease, TNF‐α inhibition may provide a means to halt depigmentation in vitiligo.