肿瘤坏死因子α拮抗剂在银屑病治疗中的应用

Tumor Necrosis Factor-α Inhibitors in the Treatment of Psoriasis

肿瘤坏死因子α(TNF-α)拮抗剂是较早用于银屑病治疗的一类生物制剂,通过中和TNF-α,阻断其在银屑病发病机制中的作用而发挥疗效。TNF-α拮抗剂在分子结构上有受体融合蛋白和单克隆抗体两大类,前者主要有依那西普(etanercept)及其生物类似物益赛普(yisaipu)等,后者则包括英夫利昔单抗(infliximab)、阿达木单抗(adalimumab)、戈利木单抗(golimumab)、赛妥珠单抗(certolizumab)等。在临床研究和应用中,TNF-α拮抗剂显示出对银屑病具有明显的疗效,而不同的制剂在使用方法、起效速度、总体疗效、安全性等方面则各有差异。TNF-α拮抗剂的主要副作用包括过敏反应、各种感染特别是结核病和乙肝的激活,以及潜在的诱发自身免疫病和肿瘤等风险,用药前需进行认真的筛查,用药过程中需密切监视,以确保患者安全。

Tumor necrosis factor α（ TNF-α） inhibitor was one of the earliest biologics applied to psoriasis. It works by neutralizing TNF-α and blocking its role in the pathogenesis of psoriasis. TNF-α inhibitors are classified into fusion proteins（ Etanercept and its bio-similar product Yisaipu） and monoclonal antibodies（ Infliximab,Adalimumab,Adalimumab and Certolizumab） in terms of molecular structure. In the clinical study and application,TNF-α inhibitors have demonstrated good efficacy in psoriasis treatment,but they differ in terms of usage,speed of drug action,overall efficacy and safety profile. Side effects of TNF-α inhibitors include anaphylaxis,exacerbation of infections especially tuberculosis and hepatitis B,as well as potential risk of inducing autoimmune disorders and tumors. Therefore,patients should be carefully screened before prescription and closely monitored during medication to ensure their safety.