[聚焦斯约格伦综合征--诊断与治疗]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2024-06-01 Epub Date: 2024-05-23 DOI:10.1055/a-2136-3498
Nadine Zehrfeld, Torsten Witte, Diana Ernst
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引用次数: 0

摘要

在诊断斯约格伦综合征时,唾液腺超声波检查(SGUS)已经得到认可,并能提高适用分类标准的特异性。OMERACT 评分用于客观化 SGUS 检查结果。在实验室诊断中,抗 SSA/Ro 抗体的亚分类以及新的生物标志物可能对诊断安全性和预期表现越来越重要。在预防方面,研究表明,不仅心理压力,心血管风险和淋巴瘤风险也能在未来更准确地识别高危患者。通过聚类分析,可以确定各种表型组别,并将临床参数分配给这些组别。2020 年,根据 SjS 的临床表现发布了治疗建议,并推荐了用于治疗系统性红斑狼疮(SLE)或类风湿性关节炎的药物。专门针对 B 细胞的治疗方法尤其多:利妥昔单抗(Rituximab)和贝利木单抗(Belimumab)已被列入 EULAR 推荐的治疗严重表现的药物,而伊那鲁单(Ianalumab)的疗效也很不错。当前研究的另一个重点是抑制免疫细胞之间的协同刺激。阿巴他赛普最近的研究结果令人失望,但伊卡利单抗(Iscalimab)和达佐达利贝普(Dazodalibep)的临床试验却显示出良好的效果。
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[Focus on Sjögren's syndrome - Diagnosis and treatment].

In the diagnosis of Sjögren's syndrome the Salivary gland sonography (SGUS) has become established and can lead to a higher specificity of the applicable classification criteria. The OMERACT score is used to objectify the SGUS findings. In laboratory diagnostics, the subspecification of anti-SSA/Ro antibodies, but possibly also new biomarkers, are becoming increasingly important regarding diagnostic safety and the expected manifestations. When it comes to prevention, it has been shown that not only psychological stress, but also cardiovascular risk and the risk of lymphoma allow high-risk patients to be identified more precisely in the future. Using cluster analyses, various phenotype groups could be identified to which clinical parameters could be assigned. In 2020, therapy recommendations were published that are based on the clinical manifestations of SjS and recommend medications that are also used in the treatment of systemic lupus erythematosus (SLE) or rheumatoid arthritis. A particularly large number of therapeutic approaches are dedicated to the B cell: Rituximab and Belimumab have been included in the EULAR recommendations for serious manifestations and Ianalumab has a promising effect. Another focus of current research is the inhibition of co-stimulation between immune cells. After recent disappointing results for Abatacept, clinical trials show promising effects on Iscalimab and Dazodalibep.

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