杨华夏, 张奉春. 系统性红斑狼疮新型生物治疗靶点:希望与挑战[J]. 协和医学杂志, 2020, 11(3): 241-246. DOI: 10.3969/j.issn.1674-9081.20200091
引用本文: 杨华夏, 张奉春. 系统性红斑狼疮新型生物治疗靶点:希望与挑战[J]. 协和医学杂志, 2020, 11(3): 241-246. DOI: 10.3969/j.issn.1674-9081.20200091
Hua-xia YANG, Feng-chun ZHANG. New Biologic Targets for Systemic Lupus Erythematosus: Hope and Challenge[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 241-246. DOI: 10.3969/j.issn.1674-9081.20200091
Citation: Hua-xia YANG, Feng-chun ZHANG. New Biologic Targets for Systemic Lupus Erythematosus: Hope and Challenge[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 241-246. DOI: 10.3969/j.issn.1674-9081.20200091

系统性红斑狼疮新型生物治疗靶点:希望与挑战

New Biologic Targets for Systemic Lupus Erythematosus: Hope and Challenge

  • 摘要: 随着贝利木单克隆抗体(肿瘤坏死因子家族B细胞活化因子拮抗剂)在中国用于治疗系统性红斑狼疮(systemic lupus erythematosus, SLE)适应证的获批, SLE的治疗逐渐迈向了生物制剂时代。SLE发病机制复杂, 包括B细胞和T细胞免疫耐受机制的破坏。本文关注SLE的新型生物治疗靶点, 以及正在进行的SLE临床试验, 围绕靶向B细胞特异性表面分子(CD20、CD19), 靶向B细胞信号通路和细胞因子(肿瘤坏死因子家族B细胞活化因子、增值诱导配体), 靶向共刺激因子减少B细胞抗原呈递(CD40及其配体、可诱导共刺激分子及其配体), 以及T细胞及信号通路(rigerimod、干扰素α、JAK-STAT)等SLE相关靶标展开讨论。总而言之, 生物靶向治疗SLE已获得一定进展, 未来前景可期。

     

    Abstract: Belimumab is a human monoclonal antibody that inhibits B-cell activating factor of the tumor necrosis factor family(BAFF). With the approval of belimumab for treating patients with systemic lupus erythematosus (SLE), targeted biologics has generally ushered a new era in the treatment of SLE. The pathogenesis of SLE involves a general breakdown in both B cell and T cell tolerance. In this review, we focused on the new promising therapeutic targets and several ongoing clinical trials for SLE. The approaches of these biologic therapeutic agents included targeting B cell selective cell surface molecules (CD20 or CD19), inhibiting B cell survival by targeting cytokines and signaling molecules (BAFF or a proliferation-inducing ligand), interfering with B cell antigen presentation by targeting co-stimulatory molecules (CD40-CD40 ligand interactions or ICOS-ICOS ligand interactions), blocking the signal pathways (rigerimod, interferon-α, or JAK/STAT), et al. Biologic target therapies for SLE have made some progress and bringing successful new biologic therapies into the clinical practice for SLE remains challenging but promising in the future.

     

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