生物制剂诱导所致自身免疫系统性疾病的研究进展

Research progress of autoimmune diseases induced by biological agents

生物制剂是具有明确靶向性的单克隆抗体或抗体融合蛋白类生物大分子药物。现已广泛用于自身免疫性风湿、消化、皮肤病和全身性疾病,其具有显著的疗效,可降低疾病并发症及死亡率。然而矛盾的是,越来越多的报道却证实接受生物制剂治疗后可出现自身免疫性疾病,包括各种全身性(狼疮、血管炎、结节病、抗磷脂综合征和炎症性肌病)和器官特异性(间质性肺病、葡萄膜炎、视神经炎、周围神经病、多发性硬化症、牛皮癣、炎症性肠病和自身免疫性肝炎)疾病。目前国内相关文献报道较少,该文综述主要目的为阐述生物制剂诱导自身免疫系统性疾病的临床特征、结果及可能的发病机制。

Biological agents are biological macromolecular drugs with clear targeting of monoclonal antibodies or antibody fusion proteins.It has been widely used in autoimmune rheumatism,digestion,skin diseases and systemic diseases.It has remarkable curative effect and can reduce the disease complications and mortality.However,paradoxically,more and more reports have confirmed that autoimmune diseases can occur after treatment with biological agents,including various systemic(lupus,vasculitis,sarcoidosis,antiphospholipid syndrome and inflammatory myopathy)and organ-specific diseases(interstitial lung disease,uveitis,optic neuritis,peripheral neuropathy,multiple sclerosis,psoriasis,inflammatory bowel disease and autoimmune hepatitis).At present,there are few relevant literature reports in China.The main purpose of this review is to elaborate the clinical characteristics,results and possible pathogenesis of autoimmune diseases induced by biological agents.