自身免疫性疾病的生理病理及其治疗意义的最新进展。

Pediatrie Pub Date : 1993-01-01
J P Revillard
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引用次数: 0

摘要

自身免疫性疾病(AID)是一种异质性的慢性炎症性疾病,似乎不是由微生物或外来生物的直接致病作用引起的。一些AID与自身抗体的产生有关,在一些患者中,这些抗体可能参与组织损伤的发展。在其他AID中,如在大多数AID的实验模型中,T细胞通过其细胞毒性活性或细胞因子的合成负责组织病变的产生。T细胞和B细胞耐受自身抗原的机制是多种多样的,它们在中央淋巴器官(胸腺、胎儿肝脏、骨髓)和外周血中都起作用。它们暗示自身反应性淋巴细胞的破坏(克隆性缺失)或其失活(克隆性能)。在分析自身免疫机制方面的最新进展开辟了新的治疗可能性,这些可能性在AID的自发和实验动物模型中进行了评估。其中最有希望的方法是干预细胞因子网络,T细胞和肽疫苗接种,口服耐受性和非消耗性单克隆抗体。
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[Recent advances in physiopathology of autoimmune diseases and their therapeutic implications].

Auto-immune diseases (AID) represent an heterogeneous group of chronic inflammatory diseases which do not seem to result from the direct pathogenic effect of microorganisms or xenobiotics. Some AID are associated with the production of autoantibodies which, in some patients, may be involved in the development of tissue damages. In other AID, as in most experimental models of AID, T cells are responsible for the generation of tissue lesions by their cytotoxic activity or by the synthesis of cytokines. Mechanisms by which T and B cells are educated to tolerate self antigens are numerous and operate both in central lymphoid organs (thymus, fetal liver, bone marrow) and at the periphery. They imply either the destruction of autoreactive lymphocytes (clonal deletion) or their inactivation (clonal anergy). Recent advances in analyzing the mechanisms of autoimmunity have opened new therapeutical possibilities which are evaluated in spontaneous and experimental animal models of AID. Among the most promising approaches are the intervention on the cytokine network, T cell and peptide vaccination, oral tolerance and non depleting monoclonal antibodies.

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