RESUMO
Systemic lupus erythematosus (SLE) is considered an autoimmune disease with multiorgan involvement. Many advances have been made during the last decade regarding inflammatory pathways, genetic and epigenetic alterations, adaptive and innate immune system mechanisms specifically involved in SLE pathogenesis. Apoptosis has been proposed as an important player in SLE pathogenesis more than a decade ago. However, only recently new key apoptotic pathways have been investigated and the link between apoptotic debris containing autoantigens, innate immunity and ongoing inflammation has been further elucidated. Better understanding of cellular mechanisms and involved cytokines contributed to the development of new biological drugs specifically addressed for SLE therapy.
RESUMO
Systemic lupus erythematosus (SLE) is the prototype of autoimmune diseases with multiorgan involvement. SLE presents many genetic and epigenetic associations and the pathogenesis is characterized by a complex network of alterations affecting both adaptative and innate immunity. The disclosure of novel mechanisms of SLE pathogenesis suggested new therapeutic targets, based on interference with the cytokine pathways or on depletion of the immune cells.
Assuntos
Imunidade Adaptativa/efeitos dos fármacos , Imunidade Inata/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Terapia de Alvo Molecular , Animais , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/etiologia , Lúpus Eritematoso Sistêmico/imunologia , Fatores de Risco , Resultado do TratamentoAssuntos
Síndrome de Behçet/tratamento farmacológico , Imunossupressores/uso terapêutico , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Uveíte/tratamento farmacológico , Adulto , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/imunologia , Feminino , Angiofluoresceinografia , Humanos , Resultado do Tratamento , Uveíte/diagnóstico , Uveíte/etiologia , Uveíte/imunologiaRESUMO
Infliximab, a chimeric monoclonal anti-TNF-alfa agent used to treat autoimmune diseases, has shown a paradoxical side effect in the development of autoimmunity. We describe a case of alopecia areata universalis associated with infliximab treatment in a patient with Behçet disease. This case suggests a complex and contradictory role of TNF-α in the pathogenesis of alopecia areata.
Assuntos
Alopecia em Áreas/induzido quimicamente , Anti-Inflamatórios/efeitos adversos , Anticorpos Monoclonais/efeitos adversos , Doenças Autoimunes/induzido quimicamente , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Alopecia em Áreas/imunologia , Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Doenças Autoimunes/imunologia , Síndrome de Behçet/tratamento farmacológico , Humanos , Infliximab , Masculino , Uso Off-LabelRESUMO
Neuromyelitis optica (NMO or Devic's syndrome) is a rare autoimmune disease, previously considered a multiple sclerosis variant. The most important laboratory and clinical features are optic myelitis and transverse myelitis, associated with neuromyelitis optica-IgG antibody (NMO-IgG) positivity. Subsequent to this immunological test being available, different groups have described the not-so-rare comorbidity of neuromyelitis optica with other systemic autoimmune diseases, systemic lupus erythematosus with secondary anti-phospholipid syndrome (APS) in particular. We describe a patient meeting both the classification criteria for primary APS and the new diagnostic criteria for neuromyelitis optica. It's important to diagnose NMO syndrome as both optic neuritis and transverse myelitis were also considered neurological complications of antiphospholipid syndrome. NMO-IgG is a new and fundamental test to decide if immunosuppressant therapy is warranted for such patients.
