新型药物治疗选择的类固醇耐火移植对宿主疾病的新药治疗选择
Iuliia Kovalenko1, Tabinda Saleem2, Mitali Shah3
1UPMC Harrisburg, Harrisburg, PA, USA.
Advances in hematology
|December 14, 2023
概括
新型疗法在干细胞移植后对固醇耐药移植对宿主疾病 (SR-GVHD) 显示出前景. 需要进一步的试验来确认这些新兴SR-GVHD治疗方法的疗效和安全性.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 移植与宿主疾病 (GVHD) 是异性干细胞移植的严重并发症.
- 皮质类固醇是主要的治疗方法,但在30-50%的病例中是无效的,导致类固醇耐药GVHD (SR-GVHD).
- SR-GVHD的预后不好,死亡率高,需要新的治疗策略.
研究的目的:
- 审查新兴的治疗方案,用于类固醇耐药的移植与宿主疾病 (SR-GVHD).
- 评估SR-GVHD新型治疗方法的疗效和安全性.
- 为了确定SR-GVHD的潜在未来治疗方法.
主要方法:
- 在PubMed,Cochrane和Embase进行的文献搜索.
- 包括潜在的第一,第二或第三阶段临床试验.
- 不包括回顾性和非原始研究.
主要成果:
- 鲁克索利提尼布已被批准用于急性GVHD,反应率高.
- 包括单克隆抗体和其他药物在内的众多药物正在针对SR-GVHD进行研究.
- 经批准的慢性GVHD治疗方法包括ruxolitinib,ibrutinib和 belumosudil,目前正在研究新疗法.
结论:
- 新型药物显示出治疗SR-GVHD的潜力.
- 需要进一步的大规模,多中心,随机临床试验来验证疗效和安全性.
- 这些新兴的治疗方法可能为SR-GVHD患者提供了改进的替代方案.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
168
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
168
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
121
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
121
Inflammatory Bowel Disease IV: Pharmacological Management
129
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
129
Tumor Immunotherapy
529
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
529
Bone Marrow Sampling and Transplants
333
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
333
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
142
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
142


