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Retracted: Galectin-1, -4, and -7 Were Associated with High Activity of Disease in Patients with Rheumatoid Arthritis. 缩回:半乳糖凝集素-1、-4和-7与类风湿关节炎患者的疾病高活性相关。
IF 4 Q4 IMMUNOLOGY Pub Date : 2020-11-28 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8364502
Autoimmune Diseases

[This retracts the article DOI: 10.1155/2019/3081621.].

[本文撤回文章DOI: 10.1155/2019/3081621.]。
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引用次数: 0
Therapeutic Plasma Exchange as a Treatment for Autoimmune Neurological Disease. 血浆置换治疗自身免疫性神经系统疾病
IF 4 Q4 IMMUNOLOGY Pub Date : 2020-07-31 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3484659
Ivana Nieto-Aristizábal, Álvaro J Vivas, Pablo Ruiz-Montaño, Cristian C Aragón, Iván Posso-Osorio, Jairo Quiñones, Julián Alejandro Rivillas, Gabriel J Tobón

Introduction: Therapeutic plasma exchange (TPE) is commonly used as treatment of certain autoimmune neurological diseases (ANDs), and its main objective is the removal of pathogenic autoantibodies. Our aim was to describe the clinical profile and the experience with the usage of TPE in patients with ANDs at our institution.

Methods: This is an observational retrospective study, including medical records of patients with diagnosis of ANDs who received TPE, between 2011 and 2018. Characteristics of TPE, such as number of cycles, type of replacement solution, and adverse effects, were evaluated. The modified Rankin Scale (mRS) was applied to measure the clinical response after the therapy.

Results: 187 patients were included with the following diagnoses: myasthenia gravis (MG), n = 70 (37%); Guillain-Barré syndrome (GBS), n = 53 (28.3%), neuromyelitis optica spectrum disorders (NMOSD), n = 35 (18.7%); chronic inflammatory demyelinating polyneuropathy (CIDP), n = 23 (12.2%); and autoimmune encephalitis (AE), n = 6 (3.2%). The most used types of replacement solution were albumin (n = 131, 70%) and succinylated gelatin (n = 45, 24%). All patients received a median of five cycles (IQR 5-5). Hypotension and hydroelectrolytic disorders were the main complications. After TPE, 99 patients (52.9%) showed improvement in the mRS scores and a statistical significance (p < 0.05) was seen between the admission score and after TPE for every diagnosis except for CIDP.

Conclusion: TPE has an adequate safety profile, and improvement in functionality in treated patients reflects its effectiveness.

治疗性血浆置换(TPE)通常用于治疗某些自身免疫性神经疾病(ANDs),其主要目的是去除致病性自身抗体。我们的目的是描述临床概况和使用TPE的经验,在我们的机构与患者的ANDs。方法:这是一项观察性回顾性研究,包括2011年至2018年期间诊断为ANDs并接受TPE的患者的医疗记录。评估TPE的特征,如循环次数、替代溶液类型和不良反应。采用改良Rankin量表(mRS)评价治疗后的临床疗效。结果:187例患者被诊断为:重症肌无力(MG), n = 70 (37%);吉兰-巴利综合征(GBS), n = 53(28.3%),视神经脊髓炎(NMOSD), n = 35 (18.7%);慢性炎性脱髓鞘性多神经病变(CIDP), n = 23 (12.2%);自身免疫性脑炎(AE), n = 6(3.2%)。使用最多的替代溶液类型是白蛋白(n = 131, 70%)和琥珀酰明胶(n = 45, 24%)。所有患者接受中位数为5个周期(IQR 5-5)。低血压和电解质紊乱是主要的并发症。TPE后mRS评分改善者99例(52.9%),除CIDP外,入院评分与TPE后比较差异均有统计学意义(p < 0.05)。结论:TPE具有足够的安全性,治疗后患者功能的改善反映了其有效性。
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引用次数: 8
The Influence of Reactive Oxygen Species in the Immune System and Pathogenesis of Multiple Sclerosis. 活性氧对免疫系统的影响及多发性硬化的发病机制。
IF 4 Q4 IMMUNOLOGY Pub Date : 2020-06-25 eCollection Date: 2020-01-01 DOI: 10.1155/2020/5793817
Mohammad Javad Tavassolifar, Mohammad Vodjgani, Zahra Salehi, Maryam Izad

Multiple roles have been indicated for reactive oxygen species (ROS) in the immune system in recent years. ROS have been extensively studied due to their ability to damage DNA and other subcellular structures. Noticeably, they have been identified as a pivotal second messenger for T-cell receptor signaling and T-cell activation and participate in antigen cross-presentation and chemotaxis. As an agent with direct toxic effects on cells, ROS lead to the initiation of the autoimmune response. Moreover, ROS levels are regulated by antioxidant systems, which include enzymatic and nonenzymatic antioxidants. Enzymatic antioxidants include superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase. Nonenzymatic antioxidants contain vitamins C, A, and E, glutathione, and thioredoxin. Particularly, cellular antioxidant systems have important functions in maintaining the redox system homeostasis. This review will discuss the significant roles of ROS generation and antioxidant systems under normal conditions, in the immune system, and pathogenesis of multiple sclerosis.

近年来,活性氧(reactive oxygen species, ROS)在免疫系统中的多种作用已被证实。活性氧由于其破坏DNA和其他亚细胞结构的能力而被广泛研究。值得注意的是,它们已被确定为t细胞受体信号传导和t细胞活化的关键第二信使,并参与抗原交叉呈递和趋化。作为一种对细胞具有直接毒性作用的药物,ROS可导致自身免疫反应的启动。此外,ROS水平受抗氧化系统的调节,包括酶和非酶抗氧化剂。酶促抗氧化剂包括超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶和谷胱甘肽还原酶。非酶抗氧化剂含有维生素C、A和E、谷胱甘肽和硫氧还蛋白。特别是,细胞抗氧化系统在维持氧化还原系统稳态方面具有重要的功能。本文将讨论正常情况下ROS生成和抗氧化系统在免疫系统中的重要作用,以及多发性硬化症的发病机制。
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引用次数: 60
Autoimmune Mechanisms of Interferon Hypersensitivity and Neurodegenerative Diseases: Down Syndrome. 干扰素过敏和神经退行性疾病的自身免疫机制:唐氏综合征。
IF 4 Q4 IMMUNOLOGY Pub Date : 2020-06-01 eCollection Date: 2020-01-01 DOI: 10.1155/2020/6876920
Ashraya Jagadeesh, Leonard E Maroun, Lisa M Van Es, Richard M Millis

Down syndrome (DS), also known as trisomy 21 (T21), is associated with interferon (IFN) hypersensitivity, as well as predilections for Alzheimer's dementia (AD) and various autoimmune diseases. IFN-α and IFN-γ receptors are encoded on chromosome 21 (Ch21). It remains unclear how other Ch21 genes contribute to the neuropathological features of DS/T21. This study tests the hypothesis that identifying IFN-stimulated response element (ISRE) control sites on Ch21 will mark novel candidate genes for DS/T21-related IFN hypersensitivity and neuropathology not previously reported to be associated with IFN functions. We performed whole chromosome searches of online databases. The general ISRE consensus and gamma interferon activation consensus sequences (GAS) were used for identifying IFN-stimulated response elements. Candidate genes were defined as those possessing two or more ISRE and/or GAS control sites within and/or upstream of the transcription start site. A literature search of gene functions was used to select the candidate genes most likely to explain neuropathology associated with IFN hypersensitivity. DOPEY2, TMEM50B, PCBP3, RCAN1, and SIM2 were found to meet the aforementioned gene search and functional criteria. These findings suggest that DOPEY2, TMEM50B, PCBP3, RCAN1, and SIM2 are genes which may be dysregulated in DS/T21 and may therefore serve as novel targets for treatments aimed at ameliorating the neuropathological features of DS/T21. Future studies should determine whether these genes are dysregulated in patients with DS, DS-related AD, and autoimmune diseases.

唐氏综合症(DS),也被称为21三体(T21),与干扰素(IFN)超敏性以及阿尔茨海默氏痴呆(AD)和各种自身免疫性疾病的倾向有关。IFN-α和IFN-γ受体编码在染色体21 (Ch21)上。目前尚不清楚其他Ch21基因如何影响DS/T21的神经病理特征。本研究验证了一个假设,即鉴定Ch21上的IFN刺激反应元件(ISRE)控制位点将标记出DS/ t21相关IFN超敏反应和神经病理学的新候选基因,这些候选基因之前未报道与IFN功能相关。我们对在线数据库进行了全染色体搜索。一般ISRE共识序列和γ干扰素激活共识序列(GAS)用于鉴定干扰素刺激的反应元件。候选基因被定义为在转录起始位点和/或上游具有两个或多个ISRE和/或GAS控制位点的基因。通过对基因功能的文献检索来选择最有可能解释与IFN超敏性相关的神经病理学的候选基因。DOPEY2、TMEM50B、PCBP3、RCAN1和SIM2符合上述基因搜索和功能标准。这些发现表明DOPEY2、TMEM50B、PCBP3、RCAN1和SIM2是DS/T21中可能失调的基因,因此可能作为旨在改善DS/T21神经病理特征的治疗的新靶点。未来的研究应该确定这些基因在DS、DS相关AD和自身免疫性疾病患者中是否失调。
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引用次数: 6
The Effects of Alternate-Day Corticosteroids in Autoimmune Disease Patients. 间隔日使用皮质类固醇治疗自身免疫性疾病的效果
IF 4 Q4 IMMUNOLOGY Pub Date : 2020-05-18 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8719284
Genny Margarita Chaia-Semerena, María Eugenia Vargas-Camaño, Cesar Daniel Alonso-Bello, Jorge Javier Guillén-Toledo, Ricardo Leopoldo Guido-Bayardo, Fernando Lozano-Patiño, Mariano Daniel Temix-Delfín, María Isabel Castrejón-Vázquez

Introduction: Several studiesdemonstrated that the use of alternate-day corticosteroid therapy maintains control of autoimmune diseases due to the prolongation of their therapeutic effect beyond their metabolic effect, with a significant decrease in side effects in patients. For this reason, the current recommendation for the use of these medications is in a short cycle to avoid adverse effects when used frequently and for prolonged periods of time.

Objectives: To learn variations in serum levels of autoantibodies in autoimmune diseases treated with steroids on alternate days, as well as whether there are differences in the response to them depending on the type of disease. Study Design. A descriptive, retrospective, and cross-sectional study was conducted in which serum autoantibody levels were compared at the time of diagnosis and three months after alternate-day corticosteroid therapy.

Results: We included 106 patients from three autoimmune connective tissue diseases (systemic lupus erythematosus, Sjögren syndrome, and Hashimoto's thyroiditis) and observed a statistically significant decrease in serum autoantibody levels both in patients with lupus and those with Hashimoto's thyroiditis, regardless of the sex of the patients, as well as the type of steroids used.

Conclusions: Treatment with alternate-day corticosteroids achieved a statistically significant decrease in serum autoantibody levels in patients with systemic lupus erythematosus and Hashimoto's thyroiditis.

几项研究表明,使用隔日皮质类固醇治疗可以维持自身免疫性疾病的控制,因为它们的治疗效果超出了它们的代谢作用,并且显著减少了患者的副作用。出于这个原因,目前建议使用这些药物的周期较短,以避免在频繁和长时间使用时产生不良反应。目的:了解交替使用类固醇治疗的自身免疫性疾病患者血清自身抗体水平的变化,以及根据疾病类型对它们的反应是否存在差异。研究设计。进行了一项描述性、回顾性和横断面研究,比较了诊断时和隔日皮质类固醇治疗后三个月的血清自身抗体水平。结果:我们纳入了106例来自三种自身免疫性结缔组织疾病(系统性红斑狼疮、Sjögren综合征和桥本甲状腺炎)的患者,观察到狼疮患者和桥本甲状腺炎患者血清自身抗体水平的统计学显著下降,而与患者的性别和使用的类固醇类型无关。结论:在系统性红斑狼疮和桥本甲状腺炎患者中,隔天使用皮质类固醇治疗可显著降低血清自身抗体水平。
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引用次数: 4
Vitamin D and Demyelinating Diseases: Neuromyelitis Optica (NMO) and Multiple Sclerosis (MS). 维生素D和脱髓鞘疾病:视神经脊髓炎(NMO)和多发性硬化(MS)。
IF 4 Q4 IMMUNOLOGY Pub Date : 2020-01-19 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8718736
Cady Rodney, Sherriann Rodney, Richard M Millis

Vitamin D deficiency is prevalent in all ages regardless of climate or geographical location and evidence is emerging that the incidence of autoimmune diseases is increasing worldwide. Women make up a large proportion of autoimmune disease diagnoses, underscoring the importance of fully elucidating the complex synergistic relationships between estrogens and vitamin D. Vitamin D receptor-activating drugs appear to enhance remyelination in patients diagnosed with multiple sclerosis (MS) and other demyelinating diseases such as neuromyelitis optica (NMO). This review is intended to update health practitioners about the potential role of vitamin D deficiency demyelination and to motivate future research on dietary recommendations for vitamin D in preventing and treating demyel1nating diseases.

无论气候或地理位置如何,维生素D缺乏症在所有年龄段都很普遍,而且越来越多的证据表明,自身免疫性疾病的发病率在全球范围内正在增加。女性在自身免疫性疾病诊断中占很大比例,这强调了充分阐明雌激素和维生素D之间复杂的协同关系的重要性。维生素D受体激活药物似乎可以增强多发性硬化症(MS)和其他脱髓鞘疾病(如视神经脊髓炎(NMO))患者的髓鞘再生。这篇综述旨在更新健康从业者关于维生素D缺乏性脱髓鞘的潜在作用,并激励未来研究维生素D在预防和治疗脱髓鞘疾病中的饮食建议。
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引用次数: 12
Significance of Anti-TPO as an Early Predictive Marker in Thyroid Disease 抗tpo作为甲状腺疾病早期预测指标的意义
IF 4 Q4 IMMUNOLOGY Pub Date : 2019-07-28 DOI: 10.1155/2019/1684074
Thushani Siriwardhane, K. Krishna, Vinodh Ranganathan, V. Jayaraman, Tianhao Wang, K. Bei, S. Ashman, Karenah E. Rajasekaran, J. Rajasekaran, H. Krishnamurthy
Even though most thyroid subjects are undiagnosed due to nonspecific symptoms, universal screening for thyroid disease is not recommended for the general population. In this study, our motive is to showcase the early appearance of thyroid autoantibody, anti-TPO, prior to the onset of thyroid hormone disruption; hence the addition of anti-TPO in conjunction with traditional thyroid markers TSH and FT4 would aid to reduce the long-term morbidity and associated health concerns. Here, a total of 4581 subjects were tested multiple times for TSH, FT4, anti-TPO, and anti-Tg and followed up for 2 years. We streamlined our subjects into two groups, A1 (euthyroid at first visit, but converted to subclinical/overt hypothyroidism in follow-up visits) and A2 (euthyroid at first visit, but converted to hyperthyroidism in follow-up visits). According to our results, 73% of hypothyroid subjects (from group A1) and 68.6% of hyperthyroid subjects (from group A2) had anti-TPO 252 (±33) and 277 (±151) days prior to the onset of the thyroid dysfunction, respectively. Both subclinical/overt hypothyroidism and hyperthyroidism showed a significantly higher percentage of subjects who had anti-TPO prior to the onset of thyroid dysfunction compared to the combined control group. However, there was no significant difference in the subjects who had anti-Tg earlier than the control group. Further assessment showed that only anti-TPO could be used as a standalone marker but not anti-Tg. Our results showcase that anti-TPO appear prior to the onset of thyroid hormone dysfunction; hence testing anti-TPO in conjunction with TSH would greatly aid to identify potentially risk individuals and prevent long-term morbidity.
尽管大多数甲状腺患者由于非特异性症状而未被诊断,但不建议对普通人群进行甲状腺疾病的普遍筛查。在这项研究中,我们的目的是展示甲状腺自身抗体抗tpo的早期出现,在甲状腺激素紊乱发作之前;因此,加入抗tpo与传统甲状腺标志物TSH和FT4将有助于减少长期发病率和相关的健康问题。本研究共对4581名受试者进行了多次TSH、FT4、抗tpo和抗tg检测,随访2年。我们将受试者分为两组,A1(首次就诊时甲状腺功能正常,但在随访中转为亚临床/显性甲状腺功能减退)和A2(首次就诊时甲状腺功能正常,但在随访中转为甲状腺功能亢进)。根据我们的研究结果,73%的甲状腺功能减退患者(A1组)和68.6%的甲状腺功能亢进患者(A2组)在甲状腺功能障碍发病前分别有252(±33)天和277(±151)天的抗tpo抗体。与联合对照组相比,亚临床/显性甲状腺功能减退和甲状腺功能亢进患者在甲状腺功能障碍发病前进行抗tpo治疗的比例明显更高。然而,早于对照组的抗tg组与对照组无显著性差异。进一步的评估表明,只有抗tpo可以作为独立的标志物,而抗tg不能。我们的研究结果表明,抗tpo出现在甲状腺激素功能障碍的发病之前;因此,结合TSH检测抗tpo将极大地有助于识别潜在风险个体并预防长期发病。
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引用次数: 32
Galectin-1, -4, and -7 Were Associated with High Activity of Disease in Patients with Rheumatoid Arthritis 半乳糖凝集素-1、-4和-7与类风湿关节炎患者疾病高活性相关
IF 4 Q4 IMMUNOLOGY Pub Date : 2019-07-22 DOI: 10.1155/2019/3081621
K. M. Vilar, M. Pereira, A. Dantas, M. Rêgo, I. Pitta, C. Marques, R. Gonçalves, Laurindo Ferreira da Rocha Júnior, A. Duarte, M. Pitta
Background Due to the variety of functions that galectins (Gal) possess, it is clear that they participate in the pathogenesis of rheumatoid arthritis (RA). Although some studies demonstrate their functions, there is still no correlation with the clinical data of the disease, having the physiological meaning still unknown. Objectives To compare serum levels of Gal-1, -4, and -7 in patients with RA and healthy controls and to correlate them with clinical parameters. Methods Serum samples were collected from patients with RA and healthy donors to determine the serum levels of Gal-1, -4, and -7. Results Serum levels of Gal-1, -4, and -7 were significantly higher in RA patients compared to controls. We evaluated disease activity (CDAI) with serum levels of galectins and found that patients who were high in disease activity had high levels of galectin compared to the moderate activity group. Galectin-4 had higher levels in patients who were in high activity when compared to the group in remission or low activity. Evaluating the activity of the individual disease (DAS28), patients in high individual activity had high levels of Gal-4 when compared to the group in remission or low activity. We also found an association between positive rheumatoid factor and Gal-1 and Gal-4 levels. Conclusion Our results show for the first time the relationship between serum levels of galectin and the clinical parameters of patients with RA. Demonstrating their role in pathogenesis, new studies with galectins are needed to assess how they function as a biomarker in RA.
由于半凝集素(galectin, Gal)具有多种功能,很明显它们参与了类风湿关节炎(RA)的发病机制。虽有研究证实其功能,但仍与本病的临床资料无相关性,其生理意义尚不清楚。目的比较类风湿关节炎患者和健康对照者血清Gal-1、-4和-7的水平,并探讨其与临床参数的相关性。方法采集RA患者和健康供者血清,测定血清中Gal-1、-4、-7的水平。结果RA患者血清Gal-1、-4和-7水平明显高于对照组。我们用血清半乳糖凝集素水平评估疾病活动性(CDAI),发现与中度活动组相比,疾病活动性高的患者具有高水平的半乳糖凝集素。高活动期患者的半乳糖凝集素-4水平高于缓解期或低活动期患者。评估个体疾病的活动性(DAS28),与缓解或低活动性组相比,高个体活动性患者具有高水平的Gal-4。我们还发现类风湿因子阳性与Gal-1和Gal-4水平之间存在关联。结论本研究结果首次揭示了RA患者血清凝集素水平与临床参数的关系。为了证明它们在发病机制中的作用,需要对凝集素进行新的研究,以评估它们如何作为RA的生物标志物发挥作用。
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引用次数: 7
Neuronal Antibodies and Associated Syndromes. 神经元抗体和相关综合征。
IF 4 Q4 IMMUNOLOGY Pub Date : 2019-07-09 eCollection Date: 2019-01-01 DOI: 10.1155/2019/2135423
Borros M Arneth
Introduction Multiple well-recognized conditions, such as Lambert–Eaton myasthenic syndrome (LEMS) and myasthenia gravis (MG), have been associated with neuronal antibodies. Materials and Methods A search was performed using Embase, PubMed, and CINAHL. An initial search of each database was conducted using keywords and terms related to the aim of the current review. Additional articles were obtained by examining the reference lists and citations in the selected records. Results The studies identified through the search process used different designs and methods to explore neuronal antibodies and associated syndromes. Previous studies have shown that neurological and psychiatric disorders can be mediated and influenced by various antibodies. The identification of autoantibodies can help with the accurate diagnosis of conditions and commencement of early treatment. Discussion A review of selected studies identified in the literature implicated that classic anti-neuronal antibodies, such as anti-Ri and anti-Hu, play a role in the development of neurological diseases. More recent studies have indicated that other novel antibodies act on neuronal cell surface antigens to contribute to the development of neurological disorders. Conclusion Existing research provides evidence revealing a spectrum of antibodies linked to the development and progression of neurological diseases. However, further antibody testing and studies should be performed to validate the relationship between conditions and antibodies.
引言:多种公认的疾病,如Lambert Eaton肌无力综合征(LEMS)和重症肌无力(MG),都与神经元抗体有关。材料和方法:使用Embase、PubMed和CINAHL进行检索。使用与当前审查目标相关的关键词和术语对每个数据库进行了初步搜索。通过检查所选记录中的参考文献列表和引文,获得了更多的文章。结果:通过搜索过程确定的研究使用了不同的设计和方法来探索神经元抗体和相关综合征。先前的研究表明,神经和精神疾病可以由各种抗体介导和影响。自身抗体的鉴定有助于准确诊断病情并开始早期治疗。讨论:对文献中选定研究的综述表明,经典的抗神经元抗体,如抗Ri和抗Hu,在神经系统疾病的发展中发挥作用。最近的研究表明,其他新型抗体作用于神经元细胞表面抗原,有助于神经系统疾病的发展。结论:现有研究提供了证据,揭示了一系列与神经系统疾病的发展和进展有关的抗体。然而,应该进行进一步的抗体测试和研究,以验证条件和抗体之间的关系。
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引用次数: 5
Case Reports of DRESS Syndrome and Symptoms Consistent with DRESS Syndrome Following Treatment with Recently Marketed Monoclonal Antibodies 最近上市的单克隆抗体治疗后的DRESS综合征病例报告和与DRESS综合征一致的症状
IF 4 Q4 IMMUNOLOGY Pub Date : 2019-06-09 DOI: 10.1155/2019/7595706
James C Di Palma-Grisi, K. Vijayagopal, Muhammad A Muslimani
Background Monoclonal antibodies constitute a potent and broadly tolerable drug class, representing for some conditions the first newly approved treatment in years. As such, many are afforded “fast-track” or “breakthrough therapy” designations by the U.S. Food and Drug Administration, leading to provisional approval before Phase III clinical trials are reported. Although these drugs are usually safe, some patients experience life-threatening complications—myositis and encephalitis have led to permanent or temporary recalls. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity condition easily missed due to its long incubation period and nonspecific presentation. This minireview is primarily intended as an abbreviated guide for practitioners who may be using these powerful treatments. Methodology We searched PubMed using a string of symptoms consistent with DRESS syndrome and monoclonal antibodies approved by the FDA since 2015. Then, we excluded studies reporting dermatological complications of reactivation of nonherpetic infection, immunodeficiency-related infection, or reactions to the injection site or infusion. We searched for and accessed prior reviews and background studies via PubMed, Mendeley, and Google Scholar. Results Two cases of DRESS syndrome were identified in the literature, both the result of treatment with daclizumab. There was one additional case of encephalitis without cutaneous symptoms caused by daclizumab. Drug-induced hypersensitivity dermatitis was reported following treatment with nivolumab and two cases of combination treatment with ipilimumab and either nivolumab or durvalumab produced maculopapular rash and bullae in the first patient and lichenoid dermatitis and blisters in the second patient. Conclusions Daclizumab was the only recently approved monoclonal antibody associated with DRESS syndrome as such. Limitations in the diagnostic reliability of DRESS syndrome as a clinical entity and the lack of negative clinical trial reporting suggest enhanced vigilance on the part of clinicians and regulators may be warranted.
单克隆抗体是一种有效且广泛耐受的药物类别,代表了近年来第一个新批准的治疗方法。因此,许多药物被美国食品和药物管理局授予“快速通道”或“突破性疗法”的称号,从而在III期临床试验报告之前获得临时批准。虽然这些药物通常是安全的,但有些患者会出现危及生命的并发症——肌炎和脑炎会导致永久性或暂时性的召回。药物反应伴嗜酸性粒细胞增多及全身症状(DRESS)综合征是一种易被忽视的超敏性疾病,其潜伏期长且表现非特异性。这篇迷你评论主要是为了给那些可能正在使用这些强有力的治疗方法的从业者提供一个简短的指南。我们使用一系列与DRESS综合征一致的症状和FDA自2015年以来批准的单克隆抗体在PubMed中进行检索。然后,我们排除了报告非疱疹性感染再激活、免疫缺陷相关感染或注射部位或输注反应的皮肤病并发症的研究。我们通过PubMed、Mendeley和Google Scholar搜索并访问了之前的评论和背景研究。结果文献中发现2例DRESS综合征,均为daclizumab治疗的结果。另外还有一例无皮肤症状的脑炎病例由daclizumab引起。在纳武单抗治疗后报告了药物性过敏性皮炎,两例伊匹单抗联合纳武单抗或杜伐单抗治疗,第一例患者出现斑疹丘疹和大疱,第二例患者出现地衣样皮炎和水疱。Daclizumab是最近批准的唯一与DRESS综合征相关的单克隆抗体。DRESS综合征作为一种临床实体的诊断可靠性存在局限性,而且缺乏负面的临床试验报告,这表明临床医生和监管机构有必要提高警惕。
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引用次数: 15
期刊
Autoimmune Diseases
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