Targeted therapies for lupus nephritis: Current perspectives and future directions.
Targeted therapies for lupus nephritis: Current perspectives and future directions.
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狼疮性肾炎的靶向治疗：目前的观点和未来的方向。
DOI：
10.1097/cm9.0000000000002959
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发表时间：
2024-01-05
影响因子：
6.1
通讯作者：
Chen, Wei
中科院分区：
文献类型：
--
作者：
Jia, Xiuzhi;Lu, Yuewen;Zheng, Xunhua;Tang, Ruihan;Chen, Wei
狼疮性肾炎（LN）是系统性红斑狼疮的一种严重表现，具有进展为终末期肾病的显著风险，死亡率增加。LN的常规治疗依赖于广谱免疫抑制剂，如糖皮质激素、吗替麦考酚酯和钙调磷酸酶抑制剂。虽然治疗方案已经发展了多年，但它们具有固有的局限性，包括非特异性靶向，大量的不良反应，高复发率以及延长的维持和缓解过程。这些缺点强调了对LN的靶向治疗策略的需要。我们对LN发病机制的理解的最新进展导致了新的治疗靶点的鉴定以及具有改善的特异性和降低的毒性的生物制剂和小分子抑制剂的出现。本文综述了LN靶向治疗的现有证据，阐明了反应和失败的生物学机制，强调了未来的挑战，并概述了后续临床试验和综合免疫调节方法的策略。
Lupus nephritis (LN), a severe manifestation of systemic lupus erythematosus, poses a substantial risk of progression to end-stage renal disease, with increased mortality. Conventional therapy for LN relies on broad-spectrum immunosuppressants such as glucocorticoids, mycophenolate mofetil, and calcineurin inhibitors. Although therapeutic regimens have evolved over the years, they have inherent limitations, including non-specific targeting, substantial adverse effects, high relapse rates, and prolonged maintenance and remission courses. These drawbacks underscore the need for targeted therapeutic strategies for LN. Recent advancements in our understanding of LN pathogenesis have led to the identification of novel therapeutic targets and the emergence of biological agents and small-molecule inhibitors with improved specificity and reduced toxicity. This review provides an overview of the current evidence on targeted therapies for LN, elucidates the biological mechanisms of responses and failure, highlights the challenges ahead, and outlines strategies for subsequent clinical trials and integrated immunomodulatory approaches.