风湿病的免疫及生物治疗进展

[][1]CalinA,ElswoodJ,RiggS,etal.Ankylosingspondylitis:ananalyticalreviewof1500patients:thechangingpatternofthedisease[J].JRheumatol,1988,15(8)1234-1238.[2]GranJT,SkomsvollJF.Theoutcomeofankylosingspondylitis:astudyof100patients[J].BrJRheumatol,1997,36(7)766-771.[3]CleggDO,RedaDJ,AbdellatifM.Comparisonofsulfasalazineandplaceboforthetreatmentofaxialandperipheralarticularmanifestationsofseronegativespondylarthropathies[J].Arthri2tisRheum,1999,42(11)2325-2329.[4]ToussirotE,WendlingD.Currentguidelinesforthedrugtreat2mentofankylosingspondylitis[J].Drugs,1998,56(2)225-240.[5]VanDerLS,VanDerHD.Ankylosingspondylitis.Clinicalfea2tures[J].RheumDisClinNorthAm,1998,24(4)663-676.[6]MaugarsY,MathisC,BerthelotJM,etal.Assessmentoftheef2ficacyofsacroiliaccorticosteroidinjectionsinspondylarthropathies:adoubleblindstudy[J].BrJRheumatol,1996,35(8)767-770.[7]DougadosM,BehierJ,JolchineI,etal.Efficacyofcelecoxib,aCOX22specificinhibitorinthetreatmentofankylosingspondyli2tis[J].ArthritisRheum,2001,44(1)180-185.[8]BiasiD,CarlettoA,CaamaschiP,etal.Efficacyofmethotrexateinthetreatmentofankylosingspondylitis:athree2yearopenstudy[J].ClinRheumatol,2000,19(2)114-117.[9]SampaioBPD,CostallatLTL,BertoloM,etal.Methotrexateinthetreatmentofankylosingspondylitis[J].ScandJRheumatol,2000,29(3)160-162.[10]MakaymowychWP,JhangriGS,LeclercqS,etal.Anopenstudyofpamidronateinthetreatmentofrefractoryankylosingspondylitis[J].JRheumatol,1998,25(4)714-717.[11]BraunJ,BollowM,NeureL,etal.Useofimmunohistologicandinsituhybridizationtechniquesintheexaminationofsacroiliacjointbiopsyspecimensfrompatientswithankylosingspondylitis[J].ArthritisRheum,1995,38(4)499-505.[12]GratacosJ,ColladoA,FilellaX,etal.Serumcytokines(IL26,TNF2,IL21andIFN2r)inankylosingspondylitis:aclosecor2relationbetweenserumIL26anddiseaseactivityandseverity[J].BrJRheumatol,1994,33(10)927-931.[13]BrandtJ,HaibelH,CornelyD,etal.Successfultreatmentofac2tiveankylosingspondylitiswiththeanti2tumornecrosisfactoramonoclonalantibodyinfliximab[J].ArthritisRheum,2000,43(6)1344-1352.[14]VanDerBF,KruithofE,BaetenD,etal.Effectsofaloadingdoseregimenofthreeinfusionsofchimericmonoclonalantibodynecrosisa(infliximab)inspondylarthropathy:anopenpilotstudy[J].AnnRheumDis,2000,59(6)428-433.[15]BrebanM,GombertB,AmorB,etal.Efficacyofthalidomideinthetreatmentofrefractoryankylosingspondylitis[J].ArthritisRheum,1999,42(3)580-581.[16]HuangF,GuJ,BraunJ,etal.Identifyingthetargetsofthalido2mideandanti2TNFantibodytreatmentsinankylosingspondyli2tis[J].ArthritisRheum,2000,43(9)396.[17],.[A].[C].:,1999.123.[18]KohWH,PandeI,SamuelsA,etal.Lowdoseamiriptylineinankylosingspondylitis:ashortterm,doubleblind,placebocon2trolledstudy[J].JRheumatol,1997,24(11)2158-2161.(:2001-05-14)(,100044)[],,[];;;;[]R971.1[]A[]1003-3734(2001)07-0488-05Advancesinimmuno2biologicaltherapyinrheumaticdiseasesLIZhan2guo(ThePeoplesHospitalofPekingUniversity,Beijing100044,China)[Abstract]Immuno2biologicaltherapyisthemajortrendfortreatmentofrheumaticdiseases.Anumberofnewagentsemergedfortreatingrheumatismsandgoodresponseswereachievedinrecent884ChineseJournalofNewDrugs2001,Vol.10No.72001107years.Inthispaper,theclinicalapplicationsofleflunomide,mycophcnolatemofetil,Enbrel,diacereinwerediscussed.[Keywords]immuno2biologicaltherapy;leflunomide;mycophenolatemofetil;entanercept;diac2erein,,1(leflunomide,)FDA1998,1999,270,(8.80.77)d,A771726,DNA,,G1,(MTX)G1,,[1],,50100mgd-1,3d20mgd-1,(1.53gd-1)MTX(7.515mg)[24],1[3]MTX[4],,612MTX6,100mgd-1,2d1020mgd-1,48,MTX[5],MTXA,,,,MTX,,100mgd-1,3d,20mgd-1,3040mgd-1,6,(8/11)ECLAM(4.11.4)(3.32.1)4,dsDNA,C3,C4,,2(entanercept)(Enbrel),ImmunexTNFTNFIgG1(Fc)TNFTNF,TNF,TNF934,1.5105,115h,(1025mg,,2),(ACR)20%50%75%,52%61%[68],MTX(1525mg)6,Enbrel25mg,2,2471%ACR20%,MTX27%[9]3InfliximabInfliximab(RemicadeTM,CA2)CentorTNF(Fab),Fc984ChineseJournalofNewDrugs2001,Vol.10No.72001107,,InfliximabTNF,TNF,6,In2fliximab(110mgkg-1)1,479%Panlus20%(6),8%[10],MTXInfliximab(310mgkg-1,,121),ACR20%59%,MTX17%428,Infliximab,C2(CRP),,Infliximab,40%55%,Infliximab[11],Infliximab,,In2fliximab4(Artodar),(diacere2in)21(IL21),,368.3,2.76.6h,:IL21IL21IL21,,,,72%83.3%,,484,100mgd-1,,,29.7%,13.6%[12]4,23,,(Carryover)[1215]A,[12,13],,,[16]5(mycophenolatemofetil,),5,(GTP)T,B,,[17,18],(),,,1.5gd-1,231.0gd-1,46[19,20]3:,,2gd-181%,25mgkg-1d-1,,[19],(11.5gd-1)1gd-1,23d0.751gm-2,1SLAM,,,,,TB,094ChineseJournalofNewDrugs2001,Vol.10No.72001107(CD68)IC,ANA,dsDNAANCA,SIL-2r,TNF,C3C4[12,13]IgA,,,,,6(tacrolimus,FK506)Streptomycestsukubaensis,,8.7h,A,A10100IL22,IL23IL24,T,1989,Crohn,5,(26mgd-1)6,ACR20%5/7ACR50%5(3)(1)(1)1,7TCRHLA2DR4/1HLA2DR4/1,Clair[21]HLA2DR4/1,HLA2DR4/11.3,413mg,681,34,,,,,HLA2DR4/1,HLA2DR4/1,,TCR,[22]99TCR2V3,V14V173IR501IR50190300g,1,34,2,,TCR2V,TCR2V,TCRIR5018,,rapamycin,IDEC2131,CD28,CII,HLA2DR1[](1956-),,:[phone],E2mail:[e-mail][][1],,,.[J].,2001,10(4)294-300.[2]SmolenJS,EmeryP.Efficacyandsafetyofleflunomideinactiverheumatoidarthritis[J].Rheumatology,2000,39(Suppl1)S48-S56.[3]SmolenJS,KaldenJR,ScottDL,etal.Efficacyandsafetyofleflunomidecomparedwithplaceboan