将主动特异性免疫治疗和细胞治疗纳入具有自身免疫性特征的间质性肺炎的生物医学治疗方案-一个案例研究

R. Moya, Mike K. S. Chan, M. Wong, D. Klokol
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引用次数: 2

摘要

非特异性间质性肺炎(NSIP)是肺间质性疾病中第二常见的形态和病理类型。相当比例的间质性肺病(ILD)患者表现出自身免疫性特征,其中包括具有多室累及的形态域和特异性自身抗体,以及与其他自身免疫性病变(如系统性红斑狼疮、类风湿性关节炎和桥本甲状腺炎)相关。非特异性间质性的症状包括潜伏的呼吸困难和干咳,伴有肺功能下降和气体交换能力降低的限制性模式。皮质类固醇、抗纤维化药物和免疫抑制剂是治疗这种疾病的经典方案,但由于IPAF的广泛异质性和缺乏这一特定亚组患者的证据,治疗应谨慎个体化。异种和/或自体肽及其衍生免疫提取物的多学科免疫学方法可能是一种诱导自身免疫耐受的方法,基于免疫调节细胞分泌的能量机制,如IL-10和转化生长因子- β (TGF- β)和t调节细胞。本文报告一例47岁女性IPAF合并组织性肺炎(OP)合并风湿病并发症的临床病例,综合采用自体主动特异性免疫治疗(ASI)、异种肽免疫治疗、臭氧自体血液治疗和营养抗氧化剂灌注治疗。综合生物医学项目于2019年7月至2020年2月运行,肺变性和依从性稳定,慢性炎症随之调节,干咳和关节疼痛逐渐减轻,疲劳减轻,睡眠质量改善,整体精力增强,药物剂量进一步减少。本文就如何利用生物医学多功能和天然工具,如自体和异种免疫治疗,结合更保守的药物治疗方案,积极解决慢性自身免疫性疾病展开了科学讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Integration of active specific immunotherapy and cell therapy into the protocols of biomedical management of interstitial pneumonia with autoimmune features – A case study
Non-specific interstitial pneumonia (NSIP) is the second most common morphological and pathological pattern of interstitial lung diseases. A significant proportion of patients with interstitial lung disease (ILD) manifest autoimmune features consisting, among others, of a morphologic domain with multi-compartment involvement and specific autoantibodies, as well as association to other autoimmune pathologies, such as systemic lupus erythematous, rheumatoid arthritis and Hashimoto thyroiditis. The symptoms of non-specific interstitial include insidious onset of dyspnea and dry cough with a restrictive pattern of decreased lung function and reduced gas exchange capacity. Corticosteroids, anti-fibrotics and immunosuppressants are the classical protocol to treat the condition, but management should be carefully individualized due to the wide heterogeneity of IPAF and lack of evidence in this particular subgroup of patients. The multidisciplinary immunological approach with xenogeneic and/or autologous peptides and its derived immune extracts might be a way to induce autoimmune tolerance, based on the anergy mechanism of secretion of immunomodulatory cytokines, such as IL-10 and transforming growth factor- β (TGF- β ) and T-regulatory cells. Here we report a clinical case of 47 years old woman with IPAF and organized pneumonia (OP) with rheumatic complications addressed integrativelly with the autologous Active Specific Immunotherapy (ASI), xenogeneic peptide immunotherapy, ozone autohemotherapy and nutritional antioxidants perfusion. The integrative biomedical program was run from July 2019 until February 2020 with stabilization of lung degeneration and compliances, consequent modulation of chronic inflammation, progressive reduction of dry cough and joint pain, less fatigue, better sleep quality, overall energy and further decreasing of pharmaceutical’s dosage. This article opens a scientific discussion on how to address positively to chronic autoimmune conditions within the use of biomedical multifunctional and natural tools like autologous and xenogeneic immunotherapy in combination with a more conservative pharmaceutical protocol.
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