多发性硬化症的自身免疫性皮肤病:并发症问题和病因治疗的影响

A. Dvornikov, E. I. Gusev, M. Martynov, N. Lashch, T. Gaydina, A. S. Chukanova, A. N. Boyko
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摘要

自身免疫性疾病(AS)的数量在不断增加,目前已超过 100 种,是临床医学的一个重要问题。随着诊断生物标志物和临床测试定义的进步,在大多数情况下可以对自身免疫性病理进行鉴别诊断,并开出个性化的免疫纠正处方。现代对强直性脊柱炎发病机制的认识是基于对自身抗原耐受性的破坏,这种破坏发生在免疫调节功能受损背景下的遗传易感个体身上。本综述以神经系统的典型强直性脊柱炎多发性硬化症(MS)为例,探讨了 MS 的常见自身免疫机制与银屑病和特应性皮炎等常见皮肤病的可能结合。药学领域的进步加快了从创造新分子到将现代致病药物引入日常临床实践的步伐。为了防止多发性硬化症的恶化和进展,目前正在使用多发性硬化症的疾病修饰疗法。这种治疗是永久性和长期性的,因此必须考虑到在这种治疗背景下出现的合并病症。综述显示了 DMT 对皮肤病表现的影响。现代生物工程药物的使用既能促进新疾病的激活和出现,又能在存在自身免疫合并症的情况下稳定患者的病情。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Autoimmune Skin Diseases in Multiple Sclerosis: Comorbidity Issues and the Impact of Pathogenetic Therapy
The number of autoimmune diseases (AS), currently numbering more than 100 nosological forms, is constantly growing and is a significant problem of clinical medicine. Advances in the definition of diagnostic biomarkers and clinical tests make it possible in most cases to carry out differential diagnosis of autoimmune pathology and prescribe personalized immunocorrection. The modern understanding of the mechanisms of AS is based on the breakdown of tolerance to their own antigens, which occurs in genetically predisposed individuals against the background of impaired immunoregulation. In this review, using the example of multiple sclerosis (MS) as a classic AS of the nervous system, a possible combination of common autoimmune mechanisms of MS and such common skin diseases as psoriasis and atopic dermatitis is considered. Advances in the field of pharmacy have accelerated the path from the creation of new molecules to the introduction of modern pathogenetic drugs into daily clinical practice. To prevent exacerbations and progression of MS, disease-modifying therapy of MS are currently used. This treatment is permanent and long-term, and it is very important to take into account the comorbid pathologies that develop against the background of this therapy. The review shows the effect of DMT on the manifestation of skin diseases. The use of modern bioengineered drugs can contribute both to the activation and emergence of new diseases, and to stabilize the patient’s condition in the presence of autoimmune comorbidity.
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