狼性炎:重新定义治疗目标
An S De Vriese1, Sanjeev Sethi2, Fernando C Fervenza3
1Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge, Brugge, Belgium; Department of Internal Medicine, Ghent University, Ghent, Belgium.
Kidney international
|November 9, 2024
概括
精确评估狼性炎活动对于定制治疗至关重要. 这项研究提出了一种动态方法,重点关注临床,免疫和功能缓解,以改善患者的治疗结果.
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
- 类风湿病学 类风湿病学
背景情况:
- 繁殖性狼性炎涉及波动的疾病活动和慢性免疫失调.
- 目前的评估方法难以区分活跃炎症和慢性损伤,影响治疗决策.
研究的目的:
- 讨论目前评估狼性炎活动的工具.
- 为狼性炎管理提出重新定义的,个性化的治疗目标.
主要方法:
- 对临床,血清学和组织学工具进行疾病活动评估的审查.
- 讨论评估治疗反应和疾病进展的生物标志物.
主要成果:
- 传统的治疗目标 (蛋白尿,功能) 并不能完全捕捉疾病的活动.
- 组织学缓解是至关重要的,因为临床缓解可能会掩盖持续的炎症.
- 缺乏新的生物标志物,而抗双链DNA抗体仍然是血清学评估的关键.
结论:
- 持续的免疫失调驱动狼性炎的活动,需要集中监测.
- 建议采用一种动态的,个性化的方法,同时实现临床,免疫和功能缓解的目标.
- 生物标志物如蛋白尿,血尿,eGFR,补充水平和抗dsDNA抗体对于实现这些目标至关重要.
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