霉酚酸酯在治疗系统性红斑狼疮肾脏损害中的应用

应用免疫抑制剂治疗系统性红斑狼疮取得了显著成就,但治疗效果及存在的副作用并不能令人真正满意,新型免疫抑制剂层出不穷。现就最近上市的免疫抑制药物霉酚酸酯治疗红斑狼疮肾脏损害的作用机制、动物实验、临床应用和副作用情况作一简要综述。     

系统性红斑狼疮患者感染输血传播病毒的检测

目的调查系统性红斑狼疮患者感染输血传播病毒的情况和危险因素。方法采用套式聚合酶链反应法检测了71例新入院的系统性红斑狼疮患者血清输血传播病毒(TTV)DNA。结果系统性红斑狼疮患者TTV感染率为31.0%,明显高于对照组。TTV感染与糖皮质激素的用量、免疫抑制剂的使用有关。结论TTV感染是系统性红斑狼疮的常见并发症,系统性红斑狼疮患者继发TTV感染易发因素是大剂量糖皮质激素、免疫抑制剂。     

生物制剂治疗系统性红斑狼疮的研究进展

系统性红斑狼疮是以免疫系统介导为主的慢性疾病。传统的治疗方法,例如糖皮质激素、免疫抑制剂仍然广泛应用于该疾病的治疗。近年来,随着SLE发病机制的研究进展,促进了SLE分子水平靶向治疗的发展。生物制剂受到了广泛关注,生物制剂与传统的糖皮质类固醇激素和免疫抑制剂相比,它能选择性地作用于自身反应性淋巴细胞或炎症介质,从而减少了对机体免疫功能的损害,同时比其他治疗的不良反应少,具有广阔的临床应用前景。文中就细胞因子相关生物制剂、针对B细胞的生物制剂、改变T细胞和B细胞相互作用的生物制剂、与免疫耐受相关的生物制剂及补体抑制剂等在红斑狼疮治疗中的应用进行介绍。     

霉酚酸酯在治疗系统性红斑狼疮肾脏损害中的应用

应用免疫抑制剂治疗系统性红斑狼疮取得了显著成就，但治疗效果及存在的副作用并不能令人真正满意，新型免疫抑制剂层出不穷。现就最近上市的免疫抑制药物霉酚酸酯治疗红斑狼疮肾脏损害的作用机制、动物实验、临床应用和副作用情况作一简要综述。     

儿童系统性红斑狼疮的进展

儿童系统性红斑狼疮是由遗传、环境和性激素等多因素共同作用引起的多系统受累的自身免疫性疾病。与成人相比，儿童系统性红斑狼疮器官受累早，病程进展更迅速。其治疗根据病情活动情况和脏器受累程度而定，以糖皮质激素和免疫抑制剂为主。环磷酰胺可有效阻止慢性肾功能衰竭的发生。对环磷酰胺治疗抵抗的顽固性儿童系统性红斑狼疮可用环孢素、咪唑立宾或利妥昔单抗。     

骁悉治疗SLE 5例观察

骁悉作为新一代免疫抑制剂，具有疗效显著、副作用轻微的特点，近年来被国内外试用于多种自身免疫性疾病的治疗。为探索其疗效及安全性，我们应用骁悉联合大剂量糖皮质激素治疗系统性红斑狼疮(SLE)5例，现报道如下。     

系统性红斑狼疮患者真菌感染的调查研究

回顾性分析120例系统性红斑狼疮患者的临床资料,了解系统性红斑狼疮患者真菌感染情况和危险因素.结果显示,系统性红斑狼疮患者真菌感染率为15.83%,真菌感染与糖皮质激素的用量、免疫抑制剂、广谱抗生素的使用有关.真菌感染是系统性红斑狼疮患者的常见并发症,其中白念珠菌感染占首位.应重视其诱发因素,早期诊断和治疗.     

霉酚酸酯的作用机制及其在皮肤科的应用

霉酚酸酯(MMF)是一种新型免疫抑制剂,是霉酚酸(MPA)的2-吗啉基乙酯化产物,能选择性地抑制T、B细胞中的次黄嘌呤核苷酸脱氢酶而发挥免疫抑制作用,不良反应较轻,近年来MMF已被用于治疗银屑病、系统性红斑狼疮等免疫性皮肤病,本文简要介绍了MMF的作用机制及其在皮肤科的应用.     

儿童系统性红斑狼疮的诊治进展

系统性红斑狼疮(SLE)是一种多系统受累的自身免疫性疾病,其中儿童期发病患者约占15%~20%。儿童患者较成人更易出现狼疮肾炎、中枢神经受累及多脏器受损,其临床表现更为复杂、疾病进展快、预后差、病死率高。儿童系统性红斑狼疮(j SLE)发病和遗传易感基因突变密切相关,研究发现维生素D缺乏是重要的诱发因素,并和疾病严重程度和脏器受累有关。2017年ACR和EULAR联合发布了SLE新的分类标准,增加了各项诊断要点的权重积分,有助于单脏器受累患者的诊断,提高了诊断特异性和敏感性。近年来达标控制治疗理念逐渐应用于儿童系统性红斑狼疮的治疗,中、重度患者常采用诱导缓解和达标控制之后的长期维持治疗。目前激素联合免疫抑制剂的治疗策略主要目的是早期控制病情活动、防止脏器受损,从而提高患儿生存率和生活质量。随着治疗理念和新型免疫抑制剂尤其是靶向治疗药物的应用,儿童SLE预后得到显著改善。     

间充质干细胞移植治疗系统性红斑狼疮的研究

系统性红斑狼疮(SLE)是自身免疫性疾病,传统治疗方法主要有糖皮质激素和免疫抑制剂等,由于长期用药部分患者出现继发感染、复发及疗程长、药物不良反应等问题,对难治性、重症SLE效果欠佳。近年来,越来越多的证据表明SLE患者有间充质干细胞(MSCs)功能异常。因此,MSCs移植治疗SLE成为一种新的方法。该文简要介绍了SLE的发病机制、MSCs的免疫学特性以及干细胞移植治疗SLE的现状。     

Epidermolysis bullosa acquisita preceding the development of systemic lupus erythematosus

In most cases of epidermolysis bullosa acquisita that occur in patients with systemic lupus erythematosus, the diagnosis of systemic lupus erythematosus is made before the development of blistering. We observed three patients with well-documented epidermolysis bullosa acquisita that developed several years before the onset of systemic lupus erythematosus. One patient was producing anti-U1RNP autoantibodies at the time epidermolysis bullosa acquisita was diagnosed, and all five produced this antibody during the systemic lupus erythematosus phase of their illness. In addition, in all five cases of epidermolysis bullosa acquisita with systemic lupus erythematosus antibodies to double-stranded DNA ultimately developed, and severe systemic lupus erythematosus and lupus nephritis developed in four patients. Sera from 15 other patients with epidermolysis bullosa acquisita without overt systemic lupus erythematosus were analyzed for systemic lupus erythematosus-related autoantibodies. Four patients were found to have at least one such autoantibody. These findings further document an association between epidermolysis bullosa acquisita and systemic lupus erythematosus and suggest that patients with systemic lupus erythematosus who present with epidermolysis bullosa acquisita may represent a subset of lupus erythematosus that puts the patient at increased risk for the development of more severe systemic illness. Patients presenting with epidermolysis bullosa acquisita, especially those who are black or Hispanic, should be monitored for the development of potentially life-threatening systemic lupus erythematosus.     

深在性红斑狼疮15例分析

本文报告本院自1961年以来所见15例深在性红斑狼疮的临床、组织病理和实验室检查资料,均有一定特征,是红斑狼疮病谱中之一少见而又不稳定的中间类型.免疫指标异常不仅是其发病基础,亦可预示其发展趋势,因此及时处理以结节损害为主要表现的深在性红斑狼疮是很重要的.     

Papulonodular mucinosis in systemic lupus erythematosus

A 41-year-old man with systemic and serological manifestations of systemic lupus erythematosus presented with a diffuse eruption comprising annular plaques. Histopathology revealed diffuse deposition of mucin throughout the dermis, consistent with papulonodular mucinosis. This uncommon entity of unclear pathogenesis has been described in systemic lupus erythematosus, discoid lupus erythematosus, and subacute cutaneous lupus erythematosus.     

Bullous Lupus: An Unusual Initial Presentation of Systemic Lupus Erythematosus in an Adolescent Girl

Abstract: Bullous systemic lupus erythematosus is a subepidermal blistering disease that occurs only rarely in a subset of patients with systemic lupus erythematosus and even less commonly in pediatric patients. Autoimmunity in bullous systemic lupus erythematosus is characterized by the presence of circulating anti‐type VII collagen antibodies. We report here a case of a child whose initial systemic lupus erythematosus presentation was a diffuse bullous eruption.     

Cutaneous lupus erythematosus: a personal approach to management

SUMMARY Skin disease in patients with lupus erythematosus may be subdivided into two broad categories - those lesions that when biopsied demonstrate interface dermatitis and those that do not demonstrate interface dermatitis. The skin lesions that are represented by the interface dermatitis include discoid lupus erythematosus, subacute cutaneous lupus erythematosus and acute cutaneous lupus erythematosus. Patients with these 'specific' manifestations have varying degrees of systemic involvement from rare systemic disease in patients with localized discoid lupus erythematosus to common and often severe involvement in patients with acute cutaneous lupus erythematosus. Patients who do not demonstrate interface dermatitis also may have systemic disease and in some instances the skin manifestations are linked to some of the more severe systemic manifestations. Many patients with cutaneous lesions characterized by the interface dermatitis can be controlled with 'standard' therapies including sunscreens, protective clothing and behavioural alteration, and topical corticosteroids with or without an oral antimalarial agent. This review presents a brief summary of each common cutaneous manifestation of lupus erythematosus, its relationship to systemic involvement and treatment issues to effectively deal with the lupus erythematosus patient who has skin disease.     

SLE患者外周血单核细胞TNFα及其受体P55和P75表达

目的 探讨单核细胞在ＳＬＥ发病中的作用。方法 应用免疫组化技术对活动期ＳＬＥ患者外周血单核细胞ＴＮＦα及其受体Ｐ５５和Ｐ７５表达进行检测。结果 活动期ＳＬＥ患者单核细胞ＴＮＦα及其受体Ｐ５５和Ｐ７５表达明显增加（ｔ分别为１１．４３、５．８３和３．９３,Ｐ分别小于０．００１、０．００１和０．００２）。结论 ＳＬＥ和ＴＮＦα及其受体Ｐ５５和Ｐ７５表达增高,单核细胞可能参与ＳＬＥ的发病过程。e     

Lepromatous leprosy complicated with systemic lupus erythematosus

This paper presents a case of lepromatous leprosy complicated with systemic lupus erythematosus and diagnosed as having typical systemic lupus erythematosus from clinical features and results of laboratory tests. We discuss the appearance of autoantibodies in systemic lupus erythematosus as well as in leprosy.     

Lupus erythematosus in childhood

Lupus erythematosus in childhood comprises the following distinctive lupus subsets: neonatal lupus erythematosus, systemic lupus erythematosus, discoid lupus erythematosus, subacute cutaneous lupus erythematosus, complement deficiency syndromes with subacute cutaneous lupus lesions, and lupus panniculitis. The clinical features and pathogeneses of each of these lupus syndromes is discussed in this review.     

Bullöser systemischer Lupus erythematodes

Bullous systemic lupus erythematosus is a rare disease associated with subepidermal blistering and, in most cases, severe systemic manifestations. We describe a 19-year-old man with systemic lupus erythematosus who developed a bullous eruption along with a flare-up of systemic manifestations during the course of his disease and discuss the different forms of bullous lesions in patients with lupus erythematosus.     

皮肤型红斑狼疮的治疗现状

皮肤型红斑狼疮是红斑狼疮病谱中相对较轻的一型,治疗上有别于系统性红斑狼疮,目前尚无固定的治疗模式。局部外用糖皮质激素是广泛采用的治疗手段之一,对各种皮肤型红斑狼疮均有效。较新型的外用制剂如他克莫司及吡美莫司,主要用于治疗对糖皮质激素和常规药物无效的皮肤型红斑狼疮。对外用药物治疗无效的皮损,可选择皮损内注射糖皮质激素,以快速发挥抗炎和免疫抑制作用。细胞毒药物和沙利度胺主要治疗复发或难治性皮肤型红斑狼疮。激光及光疗也能有效改善皮肤型红斑狼疮的皮损。