New Therapeutic Horizons for Graves' Hyperthyroidism.
New Therapeutic Horizons for Graves' Hyperthyroidism.
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DOI：
10.1210/endrev/bnaa022
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发表时间：
2020-12-01
影响因子：
20.3
通讯作者：
Pearce SHS
中科院分区：
文献类型：
--
作者：
Lane LC;Cheetham TD;Perros P;Pearce SHS
Graves'甲状腺功能亢进症的特征是存在刺激促甲状腺激素受体（TSHR）的自身抗体，导致过量甲状腺激素的不受控制的分泌。常规治疗，包括抗甲状腺药物，放射性碘或手术在过去70年中基本保持不变，对许多患者缺乏疗效，或导致终身甲状腺激素替代治疗，后两种选择。对新的治疗选择的需求，加上对基础免疫生物学的更深入了解，导致了治疗Graves甲亢的新方法的出现。目前正在研究的治疗方法包括生物制剂、小分子和肽免疫调节。人们越来越关注TSHR特异性治疗方式，这些治疗方式的优势是引出特定的、有针对性的方法，目的是避免破坏免疫系统的功能。这些疗法提供了一个新的机会来取代目前对某些Graves病患者的治疗不足，为成功恢复甲状腺功能正常而不需要持续治疗提供了希望。这些治疗方案中有几种有可能在不久的将来转化为临床实践。本文综述了近年来治疗Graves甲亢的新方法的进展和发展的各个阶段。
Graves’ hyperthyroidism is characterized by the presence of autoantibodies that stimulate the thyroid-stimulating hormone receptor (TSHR), resulting in uncontrolled secretion of excessive thyroid hormone. Conventional treatments, including antithyroid medication, radioiodine, or surgery have remained largely unchanged for the past 70 years and either lack efficacy for many patients, or result in lifelong thyroid hormone replacement therapy, in the case of the latter 2 options. The demand for new therapeutic options, combined with greater insight into basic immunobiology, has led to the emergence of novel approaches to treat Graves’ hyperthyroidism. The current therapies under investigation include biologics, small molecules, and peptide immunomodulation. There is a growing focus on TSHR-specific treatment modalities, which carry the advantage of eliciting a specific, targeted approach, with the aim of avoiding disruption of the functioning immune system. These therapies present a new opportunity to supersede the inadequate treatments currently available for some Graves’ patients, offering hope of successful restoration of euthyroidism without the need for ongoing therapy. Several of these therapeutic options have the potential to translate into clinical practice in the near future. This review provides a comprehensive summary of the recent advances and various stages of development of the novel therapeutic approaches to treat Graves’ hyperthyroidism.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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作者：
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作者：
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DOI：
10.1186/s40413-015-0063-2
发表时间：
2015
期刊：
The World Allergy Organization journal
影响因子：
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作者：
Akdis CA;Akdis M
通讯作者：
Akdis M