(优质)最新综述-类风湿关节炎治疗进展-新药和治疗策略的分析Nature reviews Rheumatology.docx
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1、最新综述一类风湿关节炎治疗进展新药和治疗策略的分析NaturereviewsRheumato1ogy类风湿关节炎(RA)以多关节炎为主要病理表现,如果不进行适当的治疗,往往会造成不可逆的关节结构损伤和多器官损伤。因此,及时有效的治疗是RA临床管理的重要环节。近年来,RA治疗模式不断转变。从甲氨蝶聆(MTX)等传统合成改善病情抗风湿药(CSDMARDs),到靶向肿瘤坏死因子(TNFX白介素(I1)-6受体等靶点的生物制剂DMARDs(bDMARDs),以及靶向合成DMARDs(tsDMARDs),例如Janus激酶(JAK)抑制剂等小分子药物。由于这些新型药物的引入,临床缓解已成为RA患者可实现
2、的治疗目标。近日,有学者针对RA领域可用的bDMARDs和tsDMARDs作系统综述,汇总各类药物进展,并就未来的治疗策啷乍简要总结。NaturereviewsRheumato1ogy(Oxford).(影响因子:7.58naturereviewsrheumato1ogyExp1orecontentvAboutthejourna1vPub1ishwithusvSubscribenaturenaturereviewsrheumatO1Oqyreviewartic1esartic1ePub1ished:MarCh2006Techno1ogyInsight:genetransferandthedes
3、ignofnove1treatmentsforrheumatoidarthritisFa1kMoritZfO1iVerDist1er,CaroIineOSPeI1RenateEGay&SteffenGay回NatUreQiniCa1PraCtiCeRheUmasiogy21153-162(2006)Citethisatic1e872Accesses10CitationsMetriCSAbstractRheumatoidarthritis(RA)isachronicinf1ammatorydiseasecharacterizedbysystemicinf1ammationandjointdest
4、ruction.Nove1therapieshaveemergedduringthepastdecade,markinganewerainthetreatmentofRA.Meanwhi1e,invivoandinvitrogene-transferstudieshaveprovidedva1uab1einsightsintomechanismsofdiseasepathogenesis.Advancedgenede1iverytechniquesandanima1mode1spromisefurtherprogressinRAresearchandthedeve1opmentofnove1t
5、herapeuticstrategiesforthisdisease.Inthisartic1eweprovideanoverviewofthewidespectrumofpotentia1targetsthathavebeenidentifiedsofar,discusscurrent1yavai1ab1egene-transfermethods,andout1inethebarriersthatneedtobeovercomefortheseapproachestobesuccessfu11yapp1iedindai1ypractice.KeyPointsCytokines,activat
6、ingfactorsofsynovia1ce11s,matrix-degradingenzymesandregu1atorsofce11surviva1andapoptosishavebeencharacterizedaspotentia1therapeutictargetsinrheumatoidarthritis(RA)Gene-transferexperimentsinanima1mode1shavebeenusefu1fortheidentificationofdiseasere1evantmo1ecu1esTheseverecombinedimmunodeficientmouseco
7、-imp1antationmode1iscurrent1ythemostinformativemode1fortheinvestigationofcytokine-independentprocessesinRAThefirstc1inica1gene-transferstudiesinRApatientshavebeenconductedandtheresu1tsareavai1ab1eAvarietyofrisksandtechnica1hurd1esneedtobeovercomebeforegene-transferapproachescanbecomeestab1ishedasthe
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