摘要
重症肌无力(myasthenia gravis,MG)是由神经肌肉接头处的特异性自身抗体引起的自身免疫性疾病。MG的传统免疫治疗药物包括糖皮质激素、免疫抑制剂、静脉注射免疫球蛋白等。虽然这些免疫抑制剂对大多数MG患者有效,但所带来的不良反应或并发症仍为MG治疗中的难题。此外,非特异性免疫抑制剂通常起效较慢,且存在骨髓抑制、增加感染及肿瘤发生的风险。随着多种新型靶向生物制剂的涌现,MG的治疗进入分子免疫时代,为患者和临床医生提供了更多的治疗选择。本文重点综述了分别作用于MG病理生理过程中不同靶点的3类新型生物制剂,包括B细胞耗竭剂、末端补体C5抑制剂以及新生儿Fc受体(FcRn)抑制剂等。与传统的免疫制剂相比,此类靶向药物在MG治疗中的副作用更少,起效更快,而且具有潜在的长期持续疾病缓解能力。
Myasthenia gravis(MG)is an autoimmune disease caused by specific autoantibodies at the neuromuscular junction.The traditional immunotherapy drugs for MG include glucocorticoids,immunosuppressants,and intravenous immunoglobulins.Although these immunosuppressants are effective for most MG patients,the adverse reactions or complications brought by these drugs remain a challenge in MG treatment.In addition,non-specific immunosuppressants often take effect slowly and carry the risk of bone marrow suppression,increased infection,and tumor development.With the emergence of various new targeted biological agents,the treatment of MG has entered the era of molecular immunity,providing patients and clinicians with more treatment options.This article reviews three types of novel biological agents that act on different targets in the pathophysiological process of MG,including B-cell depleting agents,terminal complement C5 inhibitors,and neonatal Fc receptor inhibitors.Compared with traditional immunosuppressants,these targeted drugs have fewer side effects,take effect faster,and have the potential ability for sustained and long-term remission in MG.
作者
戴廷军
焉传祝
Dai Tingjun;Yan Chuanzhu(Department of Neurology,Qilu Hospital,Shandong University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2024年第5期603-609,共7页
Journal of Chongqing Medical University
基金
国家自然科学基金面上资助项目(编号:82171395)。
