生物学的製剤による乾癬の治療  [in Japanese] Treatment of psoriasis using biologics  [in Japanese]

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Author(s)

    • 多田 弥生 TADA Yayoi
    • 東京大学医学部附属病院皮膚科 Department of Dermatology, Graduate School of Medicine, University of Tokyo
    • 佐藤 伸一 SATO Shinichi
    • 東京大学医学部附属病院皮膚科 Department of Dermatology, Graduate School of Medicine, University of Tokyo

Abstract

  乾癬とは,慢性の炎症性皮膚疾患であり,膿疱や関節炎を伴う重症型も存在する.これまで,乾癬の治療は表皮細胞の増殖抑制とT細胞の活性抑制を目的とした免疫抑制治療が主体であった.しかし,中等症以上の乾癬患者の中には従来の全身的治療法では効果が不十分であったり,臓器障害のために内服治療自体が行なえない症例もあった.近年,乾癬の研究が急速に進むにつれ,乾癬の病態形成に重要な細胞や細胞表面分子,サイトカインの存在が明らかになってきた.これに伴い,これらを標的とした生物学的製剤が次々と開発,臨床応用され,実際に乾癬に著効することがわかってきている.これらの薬剤は従来の治療法と比較して,優れた効果が早くに発現し,かつ,長期にその効果の持続が期待できる.2010年1月には抗TNF-α療法が乾癬に対する本邦初の生物学的製剤として承認された.重症で難治な乾癬患者にとっては朗報である一方,新しい薬剤であるので,その適応や効果,投与方法,併用療法の可否,長期使用の是非については,今後症例を蓄積し,慎重に検討していく必要があると思われる.<br>

  Psoriasis is a chronic inflammatory skin disease, which is characterized by red, scaly, raised plaques. Its symptoms may range in severity and there are severe clinical subtypes of psoriasis including pustular psoriasis. Pre-biological systemic therapies were targeting mainly keratinocyte proliferation and T cell activation. However, there were cases, in which these classic therapies were not fully effective or could not be used because of the accompanied severe organ failure of the psoriasis patient. Recent progress in psoriasis research has clarified which of the cells, cell surface molecules and cytokines play a pivotal role in the pathogenesis of psoriasis. Biological systemic therapies targeting these molecules have turned out to be extremely effective in treating psoriasis and are now used to treat moderate to severe psoriasis worldwide. These biological therapies are not only more effective than pre-biological systemic therapies, but also show more rapid response, and long-term efficacy is expected. The TNF-α inhibitors are now approved as the first biological therapy for psoriasis in Japan. These TNF-α inhibitors are expected to be a new standard therapy for severe psoriasis, however, since the long-term safety is an unsolved issue, careful clinical monitoring is required. (193 words)<br>

Journal

  • Japanese Journal of Clinical Immunology

    Japanese Journal of Clinical Immunology 33(3), 126-134, 2010-06-30

    The Japan Society for Clinical Immunology

References:  59

Codes

  • NII Article ID (NAID)
    10026543204
  • NII NACSIS-CAT ID (NCID)
    AN00357971
  • Text Lang
    JPN
  • Article Type
    REV
  • ISSN
    09114300
  • Data Source
    CJP  J-STAGE 
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