协和医学杂志

2020, v.11(03) 247-251

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系统性红斑狼疮药物治疗发展趋势
Trends in the Pharmacological Treatment for Systemic Lupus Erythematosus

杨念生;
YANG Nian-sheng;Department of Rheumatology,the First Affiliated Hospital,Sun Yat-sen University;

摘要(Abstract):

随着对系统性红斑狼疮(systemic lupus erythematosus,SLE)发病机制研究的深入,SLE治疗进步显著。糖皮质激素等传统药物长期应用可能引起诸多不良反用,而新药的治疗靶点越来越特异,同时毒副作应也相应减少。新批准或正在进行临床试验的药物,如利妥昔单克隆抗体、贝利木单克隆抗体、anifrolumab和巴瑞替尼等,主要靶点为淋巴细胞、细胞因子及其细胞内信号通路。联合用药可同时阻断多个靶点,提高疗效。简言之,SLE药物发展是从化学药物到生物制剂再到小分子化学抑制剂的过程,治疗方式是从非特异性抗炎到特异性免疫抑制以及多靶点治疗的螺旋式上升过程。
There have been exciting advances in the treatment for systemic lupus erythematosus(SLE) with a better understanding of the pathogenesis. Since the long term use of traditional medicines such as glucocorticoids may have negative impacts on the outcome, novel treatments have increasingly specific targets that result in fewer adverse side effects. Medicines newly approved or undergoing clinical trials, such as rituximab, belimumab, anifrolumab, and baricitinib, mainly target at lymphocytes, cytokines, or their intracellular signaling pathways. A combinatory treatment that simultaneously blocks multiple targets may bring better efficacy. Development of the pharmacological treatment is a process evolving from chemical agents to biologics and back to small molecule chemical inhibitors. The modality of treatment is involved in a spiral manner from non-specific to specific and then to the combination of multi-target therapy.

关键词(KeyWords): 系统性红斑狼疮;治疗;发病机制
systemic lupus erythematosus;treatment;pathogenesis

Abstract:

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基金项目(Foundation): 国家自然科学基金(81971519、81671593、81471598)

作者(Author): 杨念生;
YANG Nian-sheng;Department of Rheumatology,the First Affiliated Hospital,Sun Yat-sen University;

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