全身型幼年特发性关节炎的治疗:传统路径逆转了吗?
Treatment of systemic juvenile idiopathic arthritis: is the conventional approach converted?
摘要全身型幼年特发性关节炎(sJIA)是一种以发热、淋巴结大、关节炎、皮疹和浆膜炎为特征的,固有免疫失调引起的自身炎症性疾病.白细胞介素-1(IL-1)和白细胞介素-6(IL-6)在sJIA的发病机制中起重要作用.sJIA的传统治疗是激素联合慢作用药物.针对细胞因子的生物制剂治疗是近年来sJIA治疗的主要进展,研究表明早期应用生物制剂可改变sJIA的病程,从而提出sJIA可能存在潜在“治疗窗口期”.现通过综述近期文献,针对sJIA的治疗进行探讨.
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abstractsSystemic juvenile idiopathic arthritis (sJIA) is an inflammatory disorder characterized by fever,lymphadenopathy,arthritis,rash and serositis.In sJIA,systemic inflammation has been associated with dysregulation of the innate immune system,suggesting that it is an autoinflammatory disorder.Interleukin(IL)-1 and IL-6 play a major role in the pathogenesis of sJIA.Glucocorticoids and disease modifying anti-rheumatic drugs(DMARDS) are the conventional treatment of patients with sJIA.The major advances in the therapy of sJIA are the applications of IL-1 and IL-6 inhibitors and have shown to be highly effective.Recent data suggests that early cytokine blockage might alter the chronic arthritis course,which reflect a potential "window of opportunity" in the care of children with sJIA.The purpose of this article is to discuss the treatment approach of the patients with sJIA according to the recently published literature.
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