双磷酸盐(bisphosphonates,BPs)等药物通过抗血管生成,同时抑制骨吸收,进而增强骨质被广泛应用于临床,但此类药常导致颌骨严重并发症,引起广泛关注。本文对药物相关性骨坏死(medication-related osteonecrosis of the jaw,MRONJ)研究进...双磷酸盐(bisphosphonates,BPs)等药物通过抗血管生成,同时抑制骨吸收,进而增强骨质被广泛应用于临床,但此类药常导致颌骨严重并发症,引起广泛关注。本文对药物相关性骨坏死(medication-related osteonecrosis of the jaw,MRONJ)研究进行总结,为此类疾病的临床治疗提供一定帮助。展开更多
Background: Dermatomyositis (DM) is an autoimmune disorder that occurs more often inwomen than men and causes highly symptomatic and inflammatory cutaneous and proximal muscle disease. Corticosteroids have been the tr...Background: Dermatomyositis (DM) is an autoimmune disorder that occurs more often inwomen than men and causes highly symptomatic and inflammatory cutaneous and proximal muscle disease. Corticosteroids have been the treatment of choice for myositis in DM, and antimalarial agents for the skin disease of DM, with methotrexate sodium, azathioprine, mycophenolate mofetil, cyclosporine, and intravenous immunoglobulin used as steroid-sparing agents. Recently, reports supporting a role for anti-tumor necrosis factorα (TNF-α ) therapy in the treatment of DM have emerged. Observations: We describe 2 women who experienced an improvement in their DM-associated skin eruptions while taking antiestrogen medication. The first patient was taking tamoxifen, a selective estrogen receptor modulator that has been found to have anti-TNF-α properties. The second was taking anastrozole, an aromatase inhibitor. When tamoxifen therapy was discontinued after 4 years of use in the first patient, her DM rash worsened and remained difficult to control with conventional immunosuppressant medication. Conclusions: With the limited number of therapies available to manage DM skin eruptions, the discovery of novel agents effective in treating this disease is vital. Using antiestrogen medication in women with DM may result in a significant improvement in their rash, possibly via the inhibition of TNF-α production by immune or other cells. Further investigation into the use of antiestrogen therapy in DM is merited to evaluate longterm risks and benefits.展开更多
免疫检查点抑制剂作为一种新的抗肿瘤药物,可诱发“类自身免疫”毒性,即免疫相关的毒副反应(immunocheckpoint inhibitors related adverse effects,irAEs)。免疫相关性肠炎作为一种irAEs,临床治疗以激素为主,但在临床治疗过程中,因其...免疫检查点抑制剂作为一种新的抗肿瘤药物,可诱发“类自身免疫”毒性,即免疫相关的毒副反应(immunocheckpoint inhibitors related adverse effects,irAEs)。免疫相关性肠炎作为一种irAEs,临床治疗以激素为主,但在临床治疗过程中,因其临床特征不典型,如何去诊断以及激素如何足剂量。展开更多
文摘双磷酸盐(bisphosphonates,BPs)等药物通过抗血管生成,同时抑制骨吸收,进而增强骨质被广泛应用于临床,但此类药常导致颌骨严重并发症,引起广泛关注。本文对药物相关性骨坏死(medication-related osteonecrosis of the jaw,MRONJ)研究进行总结,为此类疾病的临床治疗提供一定帮助。
文摘Background: Dermatomyositis (DM) is an autoimmune disorder that occurs more often inwomen than men and causes highly symptomatic and inflammatory cutaneous and proximal muscle disease. Corticosteroids have been the treatment of choice for myositis in DM, and antimalarial agents for the skin disease of DM, with methotrexate sodium, azathioprine, mycophenolate mofetil, cyclosporine, and intravenous immunoglobulin used as steroid-sparing agents. Recently, reports supporting a role for anti-tumor necrosis factorα (TNF-α ) therapy in the treatment of DM have emerged. Observations: We describe 2 women who experienced an improvement in their DM-associated skin eruptions while taking antiestrogen medication. The first patient was taking tamoxifen, a selective estrogen receptor modulator that has been found to have anti-TNF-α properties. The second was taking anastrozole, an aromatase inhibitor. When tamoxifen therapy was discontinued after 4 years of use in the first patient, her DM rash worsened and remained difficult to control with conventional immunosuppressant medication. Conclusions: With the limited number of therapies available to manage DM skin eruptions, the discovery of novel agents effective in treating this disease is vital. Using antiestrogen medication in women with DM may result in a significant improvement in their rash, possibly via the inhibition of TNF-α production by immune or other cells. Further investigation into the use of antiestrogen therapy in DM is merited to evaluate longterm risks and benefits.
文摘免疫检查点抑制剂作为一种新的抗肿瘤药物,可诱发“类自身免疫”毒性,即免疫相关的毒副反应(immunocheckpoint inhibitors related adverse effects,irAEs)。免疫相关性肠炎作为一种irAEs,临床治疗以激素为主,但在临床治疗过程中,因其临床特征不典型,如何去诊断以及激素如何足剂量。
