斑块状银屑病生物制剂治疗后出现Th2型免疫表型转换的机制

Pathogenesis of Th2-type Immune Phenotypic Switching Induced by Biologics for Plaque Psoriasis

生物制剂及其小分子靶向药物因其卓越的疗效和较少的不良反应,逐渐成为治疗中重度斑块状银屑病患者的首选治疗方案之一。但生物制剂治疗银屑病后出现湿疹、特应性皮炎、荨麻疹等Th2型炎症性疾病的现象也受到越来越广泛的关注,其发生机制尚未完全明确。国内外许多学者都对这种现象进行了报道和研究。本文主要从遗传易感性、免疫失衡、皮肤局部微生物感染、生物制剂分子结构等方面对其机制进行阐述。

Due to their excellent efficacy and few adverse events,biologics and small-molecule drugs are becoming one of the main treatments for patients with moderate to severe plaque psoriasis.However,biologics used for treating psoriasis may induce Th2-mediated inflammatory diseases such as eczema,atopic dermatitis and urticaria,which has gained growing concern.Besides,the mechanism underlying the pathogenesis remains unclear.The phenotypic switch has been extensively studied worldwide.Here,we review recent literature on the topic and propose that the pathogenesis of phenotypic switching is associated with genetic risk,immune imbalance,skin microbial infection and the molecular structure of the biologics.