Targeted therapy seems untargeted: TNF-α antagonists in psoriasis as an example.

IF 1 Q4 DERMATOLOGY
Manahel Mahmood Alsabbagh
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引用次数: 0

Abstract

Biologic therapies have emerged as targeted treatments in psoriasis, offering personalized options for patients. However, when examining the cytokine network in psoriasis, this raises the question of whether biologics should be viewed as targeted therapies. This article reviews the literature focusing on the impact of tumor necrosis factor (TNF)-α antagonists on the cytokine profile and immunocytes in psoriasis. The literature suggests that the effects of TNF-α antagonists extend beyond TNF-α. These agents have a significant influence on various cytokines of the innate and adaptive immune system, including interferon-γ, interleukin (IL)-1, IL-4, IL-6, IL-8, IL-12, IL-17, IL-22, IL-23, and IL-24 in blood and skin. In addition, TNF-α antagonists also affect immunocyte counts, such as neutrophil elastase-positive cells. This demonstrates that, even though biologic treatments were initially designed to target specific molecules structurally, their function should not be narrowly considered targeted. This concept has important implications in clinical practice, including for the understanding and knowledgeable prediction of drug-related side effects, such as colitis, inflammatory bowel disease, myocarditis, and infections, as well as for taking necessary precautions before prescribing medications.

靶向治疗似乎没有靶向性:TNF-α拮抗剂治疗牛皮癣就是一个例子。
生物疗法已经成为银屑病的靶向治疗,为患者提供个性化的选择。然而,当检查银屑病的细胞因子网络时,这提出了是否应该将生物制剂视为靶向治疗的问题。本文综述了肿瘤坏死因子(TNF)-α拮抗剂对银屑病细胞因子谱和免疫细胞的影响。文献提示TNF-α拮抗剂的作用超出TNF-α。这些药物对先天性和适应性免疫系统的各种细胞因子有显著影响,包括血液和皮肤中的干扰素-γ、白细胞介素(IL)-1、IL-4、IL-6、IL-8、IL-12、IL-17、IL-22、IL-23和IL-24。此外,TNF-α拮抗剂也影响免疫细胞计数,如中性粒细胞弹性酶阳性细胞。这表明,尽管生物治疗最初是针对特定分子结构设计的,但它们的功能不应被狭隘地认为是有针对性的。这一概念在临床实践中具有重要意义,包括对药物相关副作用的理解和知识预测,如结肠炎、炎症性肠病、心肌炎和感染,以及在开药前采取必要的预防措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
8.30%
发文量
38
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