根据分子特征和疾病进展,推进斯蒂尔病的个性化精准治疗。

IF 15 1区 医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-10-18 DOI:10.1016/S2665-9913(24)00225-X
Yujie Shen, Jinchao Jia, Jialin Teng, Chengde Yang, Qiongyi Hu
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引用次数: 0

摘要

斯蒂尔病是一种具有典型多基因遗传背景的系统性自身炎症性疾病,其特征是多关节炎、高热、鲑鱼状皮疹和高铁蛋白血症。尽管 Still's 病的确切病因仍不清楚,但据信它受到遗传因素、感染和免疫失调的影响。目前的研究表明,中性粒细胞和巨噬细胞在 Still's 病的发病机制中起着关键作用,自然杀伤细胞、T 细胞和 B 细胞也参与其中。生物制剂的进步使治疗策略超越了传统方法,细胞因子靶向制剂在治疗斯蒂尔病方面大有可为。一些细胞因子靶向生物制剂可根据临床表现、并发症、免疫细胞和分子网络进行开发。强调通过免疫分型进行精确的临床亚型分析,并根据这些发现进行有针对性的分子治疗,对于优化治疗效果至关重要。在本综述中,我们将讨论在了解斯蒂尔病发病机制和相应治疗方法方面取得的最新进展。
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Advancing personalised precision treatment for Still's disease based on molecular characteristics and disease progression.

Still's disease, a systemic autoinflammatory disorder with a classic multigenetic background, is characterised by polyarthritis, high-spiking fever, salmon-like evanescent skin rash, and hyperferritinaemia. Although the exact cause of Still's disease remains unclear, it is believed to be influenced by genetic factors, infections, and immune dysregulation. Current studies indicate that neutrophils and macrophages play crucial roles in the pathogenesis of Still's disease, along with involvement of natural killer cells, T cells, and B cells. Advances in biologic agents have expanded treatment strategies beyond conventional approaches, with cytokine-targeted agents showing promise in the management of Still's disease. Some cytokine-targeting biologic agents can be developed based on clinical manifestations, complications, immune cells, and molecular networks. Emphasis of immunophenotyping for precise clinical subtyping and targeted molecular therapies based on these findings is crucial for optimising treatment outcomes. In this Review, we discuss the latest advancements in the understanding of Still's disease pathogenesis and corresponding therapeutic approaches.

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来源期刊
Lancet Rheumatology
Lancet Rheumatology RHEUMATOLOGY-
CiteScore
34.70
自引率
3.10%
发文量
279
期刊介绍: The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.
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