Innere Medizin (Heidelberg, Germany)最新文献_第3页

[Target organ connective tissue: the variability of systemic fibrosis]. [靶器官结缔组织：系统性纤维化的变异性]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-03-07 DOI: 10.1007/s00108-025-01868-7

Nils Schulz, Philipp Klemm, Ulf Müller-Ladner

{"title":"[Target organ connective tissue: the variability of systemic fibrosis].","authors":"Nils Schulz, Philipp Klemm, Ulf Müller-Ladner","doi":"10.1007/s00108-025-01868-7","DOIUrl":"10.1007/s00108-025-01868-7","url":null,"abstract":"The group of systemic fibrosing connective tissue diseases is remarkably diverse, comprising a wide spectrum of distinct entities. Central to their pathogenesis is the fibroblast, which, when activated by exogenous or endogenous triggers, can pathologically overproduce components of the extracellular matrix or exhibit uncontrolled proliferation. Systemic sclerosis, recognized as the prototype of systemic fibrosing diseases, belongs to the connective tissue diseases. Despite considerable advancements in the understanding of its pathogenesis, diagnosis, and treatment over recent years, systemic sclerosis remains one of the most fatal conditions among inflammatory rheumatic diseases. Its hallmark features include vasculopathy, systemic fibrosis, and autoimmunity, with common organ involvement affecting the skin, lungs, heart, gastrointestinal tract, kidneys, and musculoskeletal system. Therapeutic strategies focus on improving perfusion, controlling inflammation, and implementing antifibrotic measures. Key differential diagnoses include eosinophilic fasciitis, mixed connective tissue disease, and other overlap syndromes, which often require immunomodulatory treatment. Innovative developments in the field suggest a potential paradigm shift in the treatment of inflammatory rheumatic diseases, with cell-based therapies like CD19-depleting chimeric antigen receptor (CAR) T cell therapy showing promising early outcomes. Other systemic fibrosing diseases include scleromyxedema and scleroedema adultorum Buschke, both of which belong to the mucinoses and contribute further to the complexity of this disease group.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"678-685"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Fracture prevention with zoledronate in postmenopausal women]. 绝经后妇女用唑来膦酸钠预防骨折。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-06-24 DOI: 10.1007/s00108-025-01910-8

Ralf Schmidmaier, Sirka Nitschmann

引用次数: 0

[Cardiorenal syndrome: causes, diagnosis and treatment of congestive nephropathy]. 心肾综合征：充血性肾病的病因、诊断与治疗。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1007/s00108-025-01894-5

Manuel Wallbach, Stephan von Haehling, Michael Koziolek

引用次数: 0

[CAR T cells in non-malignant diseases]. [非恶性疾病中的CAR - T细胞]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-30 DOI: 10.1007/s00108-025-01945-x

Fabian Müller, Melanie Hagen, Georg Schett, Andreas Mackensen

{"title":"[CAR T cells in non-malignant diseases].","authors":"Fabian Müller, Melanie Hagen, Georg Schett, Andreas Mackensen","doi":"10.1007/s00108-025-01945-x","DOIUrl":"https://doi.org/10.1007/s00108-025-01945-x","url":null,"abstract":"Background: Chimeric antigen receptor (CAR) T cells specific for CD19 or B cell maturation antigen (BCMA) are now the standard treatment for relapsed/refractory B cell neoplasms. Because autoreactive B cells play a key role in the pathogenesis of autoimmune diseases (AID), it has been hypothesized that B cell-specific CAR-T cells eliminate autoreactive B cell clones via a deep depletion of B cells and lead to a reset of the immune system. Initial pilot studies with CAR T cells against CD19 in rheumatologic and neurologic AIDs have confirmed this hypothesis and led to sustained drug-free remission of the diseases.Objective: The aim of this review article is to summarize and evaluate these novel developments.Methods: Initial case series and results of early clinical trials on the different entities and the current understanding of the underlying new treatment concepts are presented.Results: In a number of B cell-driven AIDs, such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc) or idiopathic inflammatory myositis (IIM), B cell-specific CAR T cell treatment was able to induce deep and sustained remission and lead to clinical improvement of organ damage. Initial successes have also been recorded in other hematologic, neurologic and dermatologic B cell-mediated AIDs. In addition, there are promising CAR T cell-based concepts for combating chronic infectious diseases, such as human immunodeficiency virus (HIV) or hepatitis B, transplant rejection and type 1 diabetes mellitus.Conclusion: The use of CAR T cell treatment in severe forms of chronic non-malignant diseases represents a novelty in medicine and opens up groundbreaking new possibilities and concepts for treatment.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Monoclonal antibodies in patients with chronic inflammatory bowel diseases]. 慢性炎症性肠病患者的单克隆抗体研究

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-30 DOI: 10.1007/s00108-025-01920-6

Elisabeth Schnoy, Sirka Nitschmann

引用次数: 0

[Impaired consciousness and hemiparesis following CVC removal: a rare complication]. [CVC切除后意识受损和偏瘫：罕见并发症]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-28 DOI: 10.1007/s00108-025-01936-y

Josef Mohammad, Niklas Görnitz, Willi Karaszewski, Ariane Thon-Markau, Oliver Müller, Christian von Heymann, Georg Brinkhaus, Rolf Otto Reiter, Carsten Büning

引用次数: 0

[Intensive blood pressure control in patients with type 2 diabetes mellitus]. 2型糖尿病患者强化血压控制

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-27 DOI: 10.1007/s00108-025-01924-2

Kristina Striepe, Sirka Nitschmann, Roland E Schmieder

引用次数: 0

[CAR T cells in solid tumors: resistance mechanisms]. CAR - T细胞在实体瘤中的抵抗机制

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-25 DOI: 10.1007/s00108-025-01943-z

Markus Barden, Astrid Holzinger, Hinrich Abken

{"title":"[CAR T cells in solid tumors: resistance mechanisms].","authors":"Markus Barden, Astrid Holzinger, Hinrich Abken","doi":"10.1007/s00108-025-01943-z","DOIUrl":"https://doi.org/10.1007/s00108-025-01943-z","url":null,"abstract":"Background: Chimeric antigen receptor (CAR) T cell treatment is based on the concept of specifically targeting the patient's cytolytic T cells against tumors using a synthetic receptor signaling molecule (CAR).Objective: While CAR T cells show unprecedented efficacy against hematological neoplasms, CAR T cell treatment of solid tumors has so far been largely disappointing, with causes still being only partially understood.Method: Presentation of the dominant mechanisms that prevent CAR T cell activation in solid tumors and strategies to overcome these obstacles.Results: Preclinical research on tumor models and clinical trials in recent years have shown that CAR T cell activation is effectively suppressed in many solid tumors by the prevention of T cell penetration into the tumor as well as active suppression of T cell functions and metabolic conditions that limit T cell survival within the tumor. To overcome these obstacles, various strategies are being tested experimentally and clinically, such as pretreatment of tumors, increasing T cell resistance to suppressive cytokines and metabolites as well as activation of resident immune cells by CAR-mediated release of therapeutically effective cytokines (T cells redirected for unrestricted cytokine-mediated killing, TRUCK).Conclusion: There is considerable developmental potential to make CAR T cell treatment effective against solid tumors. Novel strategies that use CAR T cells as \"biopharmaceutical factories\" (TRUCK) to selectively activate natural killer (NK) cells and macrophages in tumor tissues recently entered the clinical trial stage.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Hemodynamically relevant cardiac relapse of diffuse large B-cell lymphoma]. 弥漫性大b细胞淋巴瘤的血流动力学相关性心脏复发。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-24 DOI: 10.1007/s00108-025-01937-x

Jan-Niklas Krohn, Christina Bermel, David Nisenbaum, Stefan Knop

引用次数: 0

[Caffeine intoxication with suicidal intent]. [咖啡因中毒并有自杀意图]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-06-23 DOI: 10.1007/s00108-025-01938-w

Sabrina Uehlein, Reinhard Schneider, Klaus Stahl, Katharina Dechant

引用次数: 0