Drug-induced autoimmunity
Drug-induced autoimmunity
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DOI：
10.1016/j.berh.2004.05.006
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发表时间：
2004-10-01
影响因子：
5.2
通讯作者：
Olsen, NJ
中科院分区：
文献类型：
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作者：
Olsen, NJ
药物引起的自身免疫综合征已被认识多年。典型的表现是药物诱发的狼疮，这是一种与抗组蛋白抗体产生相关的特发性疾病，通常较温和。这种模式现在正在发生变化，部分原因是许多新药已被引入临床实践以治疗自身免疫性疾病，包括传统药物和生物制品。药物引起的自身免疫综合征的数量和复杂性有所增加，并且许多现在与自身抗体有关，而自身抗体通常被定义为仅限于特发性疾病状态。此外，其中一些药物引起的综合征具有危及生命的并发症，因此在更迫切需要建立正确的诊断时，识别药物引起的疾病变得更加困难。许多报告仅限于案例描述，很少进行受控调查。尽管如此，还是有可能得出一种方法来考虑这些过程可能发生的可能机制。本章将考虑这些拟议的机制，并使用一些相关药物来说明可能的发病途径。
Drug induced autoimmune syndromes have been recognized for many years. The classical presentation is that of drug-induced lupus, a generally milder version of the idiopathic disorder that is associated with production of antihistone antibodies. This pattern is now changing, in part due to the many new drugs that have been introduced into clinical practice for treatment of autoimmune diseases, including both conventional pharmaceuticals and biologicals. The number and complexity of drug-induced autoimmune syndromes has increased, and many are now associated with autoantibodies that have been classically defined as limited to idiopathic disease states. Furthermore, some of these drug-induced syndromes have life-threatening complications, so that recognition of drug-induced disease has become more difficult at a time when it is more urgent to establish a correct diagnosis. Many reports are limited to case descriptions, and few controlled investigations have been carried out. Nevertheless, it is possible to derive an approach to considering possible mechanisms by which these processes may take place. This chapter will consider these proposed mechanisms, using some of the implicated drugs to illustrate possible pathogenetic pathways.