With the advent of biological therapies, considerable advances have been achieved in the treatment of inflammatory arthritis. These have arisen primarily from studies elucidating mechanisms of pathophysiology and are best exemplified in the wide use of tumour necrosis factor (TNF) blockade in several rheumatic diseases. The identification of additional pro-inflammatory factors in rheumatic diseases and an understanding of their effector function, now offers major possibilities for the generation of novel therapeutics. To address unmet clinical need, such interventions will ideally fulfil several of the following criteria: (1) control of inflammation, (2) modulation of underlying immune dysfunction - promoting the re-establishment of immune tolerance, (3) protection of targeted tissues such as bone and cartilage - this should encompass promoting healing of previously damaged tissues, (4) preservation of host immune capability - to avoid profound immune suppression and (5) amelioration of co-morbidity associated with underlying inflammatory arthritis. This short review will consider those novel cytokine activities that represent optimal utility as therapeutic targets. Since we wish to reflect the current predominant research effort, we will focus primarily on rheumatoid arthritis (RA) based studies.

译文

随着生物疗法的出现,在炎性关节炎的治疗方面取得了相当大的进步。这些主要来自阐明病理生理机制的研究,并且在几种风湿性疾病中广泛使用肿瘤坏死因子(TNF)阻断是最好的例证。风湿性疾病中其他促炎因子的鉴定以及对它们的效应器功能的了解,现在为产生新疗法提供了主要可能性。为了满足未满足的临床需求,这些干预措施将理想地满足以下几个标准:(1)控制炎症,(2)调节潜在的免疫功能障碍-促进免疫耐受的重建,(3)保护目标组织,例如作为骨骼和软骨-这应包括促进先前受损组织的愈合,(4)保持宿主免疫能力-避免深刻的免疫抑制,以及(5)减轻与潜在炎症性关节炎相关的合并症。这篇简短的评论将考虑那些代表最佳效用的新型细胞因子活性作为治疗靶标。由于我们希望反映当前的主要研究成果,因此我们将主要关注基于类风湿关节炎(RA)的研究。

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