肿瘤坏死因子α抑制剂诱导的银屑病研究进展

umor necrosis factor-αinhibitor-induced psoriasis

近年来肿瘤坏死因子α(TNF-α)抑制剂用于治疗多种炎症性疾病取得显著疗效,但同时也出现了一种不容忽视的、矛盾的药物不良反应,即其可诱发部分患者出现银屑病样表现,称之为TNF-α抑制剂诱导的银屑病,病理表现可为银屑病样改变,也可为海绵状改变,发病机制可能与TNF-α和Ⅰ型干扰素之间平衡失调、白细胞介素23/Th17细胞轴参与、感染有关。本文对TNF-α抑制剂诱导的银屑病的流行病学、组织学特征及其可能的发病机制做一阐述,为识别和治疗TNF-α抑制剂诱导的银屑病提供依据。

Tumor necrosis factor-α(TNF-α)inhibitors have been widely used and proven to be effective in the treatment of various inflammatory disorders in recent years,but there is a noteworthy and paradoxical adverse drug reaction that cannot be ignored,that is,TNF-α inhibitor-induced psoriasis.Its pathological manifestations could be psoriasiform or spongiotic changes,and its pathogenesis may be related to the imbalance between TNF-α and type Ⅰ interferon,the involvement of interleukin-23/T helper 17 axis,or infection.This review elaborates the epidemiological,histopathological features and possible pathogenesis of TNF-α inhibitor-induced psoriasis,and provides a basis for recognition and treatment of TNF-α inhibitor-induced psoriasis.