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Medical Diagnosis 2025
I型干扰素与系统性红斑狼疮
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Abstract:
系统性红斑狼疮(systemic lupus erythematosus, SLE)是一种慢性全身性异质性自身免疫性疾病，其特点是由于免疫系统的失调(包括先天免疫和适应性免疫)、细胞因子上调、补体激活、致病性自身抗体的产生和免疫复合物的沉积，最终导致机体的单个或多个器官先后或同时受损。SLE发病机制错综复杂，临床表现、病程进展及严重程度多样化，这给诊断和治疗均带来一定的挑战。目前干扰素作为SLE发病机制的关键细胞因子已普遍达成共识，干扰素的过量产生不仅发生在已确诊的SLE患者中，还出现在无症状的临床前自身免疫阶段，以此引发了人们对干扰素在SLE信号传导通路及临床应用的极大兴趣和深入研究。所以，明确干扰素的产生、功能及异常免疫调节对SLE的诊治具有深远的意义。在本文中，我们将对有关I型干扰素(IFN-I)在SLE中的产生来源、基因表达、作用机制、临床影响、检测方法及治疗应用展开综述，目的是阐明SLE中I型干扰素的发病机制及治疗进展，希望未来靶向I型干扰素制剂能够为SLE患者带来更行之有效的治疗。
Systemic lupus erythematosus (SLE) is a chronic, heterogeneous autoimmune disease characterized by dysregulation of the immune system (including innate and adaptive immunity), cytokine upregulation, complement activation, production of pathogenic autoantibodies, and deposition of immune complexes. Eventually, one or more organs of the body are damaged successively or simultaneously. The pathogenesis of SLE is complex, and the clinical manifestations, course progression and severity of SLE are diverse, which brings certain challenges to diagnosis and treatment. At present, interferon has been widely recognized as a key cytokine in the pathogenesis of SLE. The excessive production of interferon not only occurs in diagnosed SLE patients, but also appears in the asymptomatic preclinical autoimmune stage, which has triggered great interest and in-depth research on the signal pathway and clinical application of interferon in SLE. Therefore, understanding the production, function and abnormal immune regulation of interferon has far-reaching significance for the diagnosis and treatment of SLE. In this paper, we will review the generation source, gene expression, mechanism of action, clinical impact, detection methods and therapeutic application of type I interferon (IFN-I) in SLE, with the purpose of clarifying the pathogenesis and treatment progress of type I interferon in SLE, hoping that targeted type I interferon preparations can bring more effective treatment for SLE patients in the future.
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