改变疾病的抗风湿药对老年风湿性关节炎患者认知功能的影响
Seyedeh D Fazel1, Massimo Carollo2, Lisanne Tap1
1Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Room Rg-525, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Drugs & aging
|March 15, 2025
概括
改变疾病的抗风湿药物 (DMARDs) 可能会影响类风湿性关节炎 (RA) 患者的认知功能. 一些DMARDs,特别是生物药物,通过减少神经炎症来保持认知的潜力,但证据是混合的.
科学领域:
- 类风湿病学 类风湿病学
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
背景情况:
- 类风湿性关节炎 (RA) 与系统性炎症有关,这可能导致神经退行和认知障碍.
- 机制包括血脑屏障的破坏,微质激活和细胞因子介导的神经元损伤.
研究的目的:
- 审查疾病修饰性抗风湿药物 (DMARD) 对 RA 患者认知功能的影响.
- 探索炎症途径,将RA系统性炎症与神经炎症和认知衰退联系起来.
主要方法:
- 审查关于DMARDs (csDMARDs,bDMARDs,tsDMARDs) 和它们对认知功能的影响的现有文献.
- 专注于免疫调节机制和细胞因子向 (例如TNF-α,IL-6).
主要成果:
- 针对TNF-α和IL-6的生物DMARDs (bDMARDs) 可能会减轻神经炎症并保持认知能力.
- 传统的合成DMARDs (csDMARDs),如甲基,具有复杂的,有时相互冲突的认知效应.
- 像JAK抑制剂这样的新兴疗法显示出潜力,但需要更多的临床数据.
结论:
- 虽然DMARDs可能会对RA的认知衰退产生保护作用,但研究结果不一致.
- 整合RA和认知健康的个性化治疗至关重要.
- 需要进一步的强大,前性研究来澄清DMARDs的认知影响和机制.
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