Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy.
Identifieur interne : 000A01 ( Main/Exploration ); précédent : 000A00; suivant : 000A02Pathophysiology of large vessel vasculitis and utility of interleukin-6 inhibition therapy.
Auteurs : Hajime Yoshifuji [Japon]Source :
- Modern rheumatology [ 1439-7609 ] ; 2019.
Descripteurs français
- KwdFr :
- Anticorps monoclonaux humanisés (effets indésirables), Anticorps monoclonaux humanisés (immunologie), Anticorps monoclonaux humanisés (usage thérapeutique), Artérite à cellules géantes (traitement médicamenteux), Artérite à cellules géantes (étiologie), Essais cliniques comme sujet, Humains, Interleukine-6 (antagonistes et inhibiteurs), Interleukine-6 (immunologie), Maladie de Takayashu (traitement médicamenteux), Maladie de Takayashu (étiologie).
- MESH :
- antagonistes et inhibiteurs : Interleukine-6.
- effets indésirables : Anticorps monoclonaux humanisés.
- immunologie : Anticorps monoclonaux humanisés, Interleukine-6.
- traitement médicamenteux : Artérite à cellules géantes, Maladie de Takayashu.
- usage thérapeutique : Anticorps monoclonaux humanisés.
- étiologie : Artérite à cellules géantes, Maladie de Takayashu.
- Essais cliniques comme sujet, Humains.
English descriptors
- KwdEn :
- Antibodies, Monoclonal, Humanized (adverse effects), Antibodies, Monoclonal, Humanized (immunology), Antibodies, Monoclonal, Humanized (therapeutic use), Clinical Trials as Topic, Giant Cell Arteritis (drug therapy), Giant Cell Arteritis (etiology), Humans, Interleukin-6 (antagonists & inhibitors), Interleukin-6 (immunology), Takayasu Arteritis (drug therapy), Takayasu Arteritis (etiology).
- MESH :
- chemical , adverse effects : Antibodies, Monoclonal, Humanized.
- chemical , antagonists & inhibitors : Interleukin-6.
- chemical , immunology : Antibodies, Monoclonal, Humanized, Interleukin-6.
- chemical , therapeutic use : Antibodies, Monoclonal, Humanized.
- drug therapy : Giant Cell Arteritis, Takayasu Arteritis.
- etiology : Giant Cell Arteritis, Takayasu Arteritis.
- Clinical Trials as Topic, Humans.
Abstract
Takayasu arteritis (TAK) and giant cell arteritis (GCA) affect mainly large- and medium-sized arteries. In refractory cases, vascular remodeling progresses and leads to serious outcomes. Studies have demonstrated that cytokines such as interleukin (IL)-6 play crucial roles in the pathophysiology of TAK and GCA. Recently, randomized controlled trials on IL-6 inhibition therapy using tocilizumab (TCZ) were performed, and significant effects were exhibited. The purposes of conventional treatments have been to improve symptoms and decrease the levels of inflammatory markers. Arterial changes have been considered as damages. However, after TCZ came into practical use, establishment of treat to target is desired to prevent vascular remodeling. In contrast, a combination therapy of glucocorticoids (GCs) and TCZ notably increases the risk of infections. When TCZ is used, careful attention must be paid to possible infections, and dose of GC should be tapered as much as possible. Future tasks are to establish indication and dosage of TCZ, indication for discontinuation of TCZ due to remission, efficacy of TCZ monotherapy, and protocols of TCZ for pediatric cases.
DOI: 10.1080/14397595.2018.1546358
PubMed: 30427262
Affiliations:
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Le document en format XML
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first="Hajime" last="Yoshifuji">Hajime Yoshifuji</name><affiliation wicri:level="1"><nlm:affiliation>a Department of Rheumatology and Clinical Immunology , Graduate School of Medicine, Kyoto University , Sakyo-ku , Kyoto , Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>a Department of Rheumatology and Clinical Immunology , Graduate School of Medicine, Kyoto University , Sakyo-ku , Kyoto </wicri:regionArea><wicri:noRegion>Kyoto </wicri:noRegion></affiliation></author></analytic><series><title level="j">Modern rheumatology</title><idno type="eISSN">1439-7609</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antibodies, Monoclonal, Humanized (adverse effects)</term><term>Antibodies, Monoclonal, Humanized (immunology)</term><term>Antibodies, Monoclonal, Humanized (therapeutic use)</term><term>Clinical Trials as Topic</term><term>Giant Cell Arteritis (drug therapy)</term><term>Giant Cell Arteritis (etiology)</term><term>Humans</term><term>Interleukin-6 (antagonists & inhibitors)</term><term>Interleukin-6 (immunology)</term><term>Takayasu Arteritis (drug therapy)</term><term>Takayasu Arteritis (etiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anticorps monoclonaux humanisés (effets indésirables)</term><term>Anticorps monoclonaux humanisés (immunologie)</term><term>Anticorps monoclonaux humanisés (usage thérapeutique)</term><term>Artérite à cellules géantes (traitement médicamenteux)</term><term>Artérite à cellules géantes (étiologie)</term><term>Essais cliniques comme sujet</term><term>Humains</term><term>Interleukine-6 (antagonistes et inhibiteurs)</term><term>Interleukine-6 (immunologie)</term><term>Maladie de Takayashu (traitement médicamenteux)</term><term>Maladie de Takayashu (étiologie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term></keywords><keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Interleukin-6</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term><term>Interleukin-6</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term></keywords><keywords scheme="MESH" qualifier="antagonistes et inhibiteurs" xml:lang="fr"><term>Interleukine-6</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Giant Cell Arteritis</term><term>Takayasu Arteritis</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Giant Cell Arteritis</term><term>Takayasu Arteritis</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term><term>Interleukine-6</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Artérite à cellules géantes</term><term>Maladie de Takayashu</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anticorps monoclonaux humanisés</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Artérite à cellules géantes</term><term>Maladie de Takayashu</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Clinical Trials as Topic</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Essais cliniques comme sujet</term><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Takayasu arteritis (TAK) and giant cell arteritis (GCA) affect mainly large- and medium-sized arteries. In refractory cases, vascular remodeling progresses and leads to serious outcomes. Studies have demonstrated that cytokines such as interleukin (IL)-6 play crucial roles in the pathophysiology of TAK and GCA. Recently, randomized controlled trials on IL-6 inhibition therapy using tocilizumab (TCZ) were performed, and significant effects were exhibited. The purposes of conventional treatments have been to improve symptoms and decrease the levels of inflammatory markers. Arterial changes have been considered as damages. However, after TCZ came into practical use, establishment of treat to target is desired to prevent vascular remodeling. In contrast, a combination therapy of glucocorticoids (GCs) and TCZ notably increases the risk of infections. When TCZ is used, careful attention must be paid to possible infections, and dose of GC should be tapered as much as possible. Future tasks are to establish indication and dosage of TCZ, indication for discontinuation of TCZ due to remission, efficacy of TCZ monotherapy, and protocols of TCZ for pediatric cases.</div></front></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Yoshifuji, Hajime" sort="Yoshifuji, Hajime" uniqKey="Yoshifuji H" first="Hajime" last="Yoshifuji">Hajime Yoshifuji</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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