诊断学理论与实践 ›› 2024, Vol. 23 ›› Issue (03): 278-284.doi: 10.16150/j.1671-2870.2024.03.005
收稿日期:
2024-05-13
接受日期:
2024-05-28
出版日期:
2024-06-25
发布日期:
2024-06-25
通讯作者:
厉小梅 E-mail:lixiaomei@ustc.edu.cn基金资助:
Received:
2024-05-13
Accepted:
2024-05-28
Published:
2024-06-25
Online:
2024-06-25
摘要:
干燥综合征(Sjögren's syndrome, SS)是一种常见的全身性自身免疫性疾病,主要累及外分泌腺体,病理特征为淋巴细胞和浆细胞浸润。SS患者的主要临床表现为口干、眼干,还可出现脏器(如消化道、肺、肾脏等)受累。我国SS患病率为0.29%~0.77%,其中老年人的SS患病率为3.00%~4.00%。欧洲地区SS患病率约为0.23%。SS发病涉及多种细胞和细胞因子的相互作用,包括唾液腺上皮细胞、T细胞、B细胞、树突状细胞、干扰素(interferon, IFN)、白细胞介素(interleukin, IL)、肿瘤坏死因子(tumor necrosis factor, TNF)和炎症小体等。目前,SS的腺体治疗以局部治疗为主,系统性受累的治疗方案主要借鉴其他自身免疫性疾病,尚无获批的针对性药物。SS的靶向治疗药物中,B细胞靶向治疗药物中,研究最多的是利妥昔单抗,其对存在冷球蛋白血管炎的SS患者显示出改善唾液的疗效;BAFF抑制剂、靶向CD40和间充质干细胞等也显示了一定疗效。对于大多数存在系统损害的SS患者,糖皮质激素(glucocorticoids, GCs)是一线治疗用药。免疫抑制剂和生物制剂作为二线用药,用于GCs耐受或抵抗的SS患者。在SS的发病机制中已经确定了许多潜在的治疗靶点,但只有少部分药物可转化为临床应用。当前,需要在全面评估患者病情、借助多学科协助的基础上,联合应用现有药物,制定出相对安全、有效、不良反应较小的治疗方案。靶向治疗、低不良反应以及多药物联合仍是未来SS药物研究的重点。
中图分类号:
袁祥, 厉小梅. 干燥综合征发病免疫机制研究现状及靶向治疗策略进展[J]. 诊断学理论与实践, 2024, 23(03): 278-284.
YUAN Xiang, LI Xiaomei. Advances in current research on the immunopathogenesis of Sjögren’s syndrome and targeted therapeutic strategies[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(03): 278-284.
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