对渐进性耐火性IgA脏病患者进行IL-17阻断的后续给予帕里卡尔西托尔
Miguel G Uriol-Rivera1,2, Aina Obrador-Mulet3,4, Maria Rosa Juliá5,4
1Nephrology Department, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain. miguelg.uriol@ssib.es.
Scientific reports
|February 28, 2024
概括
一种新型的连续疗法,结合了帕里卡尔西托和抗干白素17A (抗IL-17A) 的新型连续疗法,显著降低了蛋白尿症,并减缓了患有类固醇耐药IgA脏病 (r-IgAN) 的患者的功能下降. 这种治疗也改变了T辅助细胞种群,为治疗这种罕见的病提供了新的希望.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 对标准治疗耐药的渐进性IgA质炎症 (r-IgAN) 缺乏确定的治疗方法.
- 对影响肠-轴的免疫媒介疾病,正在探索17 (IL-17) 介质蛋白阻塞.
- 以前的IL-17A抑制在某些条件下表现出矛盾的效应,可能与T细胞反应失衡有关.
研究的目的:
- 在r-IgAN患者中,评估与帕里卡尔西托尔连续治疗的疗效和安全性,其次是抗IL-17A (secukinumab).
- 评估这种新型治疗对蛋白尿,功能和循环T辅助细胞种群的影响.
主要方法:
- 七名接受r-IgAN治疗的患者接受了口服帕里卡尔西托尔至少六个月.
- 皮下抗IL-17A (secukinumab) 被添加到治疗方案中.
- 患者的平均随访时间为28个月,评估蛋白尿,估计的淋巴细胞过率 (eGFR) 和T细胞子集.
主要成果:
- 蛋白尿症减少了显著的71% (P < 0.001).
- 在大多数患者中,年度eGFR下降速度减缓了4.9mL/min/1.73m2 (P = 0.046).
- 循环Th1,Th17和Treg细胞保持稳定,而Th2细胞减少,改变Th1/Th2比率. 观察到Th17.1细胞的增加.
结论:
- 这种连续的帕里卡尔西托尔和抗IL-17A疗法在r-IgAN患者中显示出有前途的功能益处.
- 治疗似乎调节T辅助细胞种群,可能通过稳定Th1/Th17反应和减少Th2细胞.
- 这种方法为治疗耐火性IgA病提供了潜在的新疗法策略.
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