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ANCA関連血管炎の病態と治療における最近の知見


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Title: ANCA関連血管炎の病態と治療における最近の知見
Other Titles: Progress in pathogenesis and therapy of vasculitis syndrome
Authors: 折口, 智樹 / 一瀬, 邦弘 / 玉井, 慎美 / 中村, 英樹 / 川上, 純 / 江口, 勝美
Authors (alternative): Origuchi, Tomoki / Ichinose, Kunihiro / Tamai, Mami / Nakamura, Hideki / Kawakami, Atsushi / Eguchi, Katsumi
Issue Date: Dec-2007
Publisher: 日本臨床免疫学会 / The Japan Society for Clinical Immunology
Citation: 日本臨床免疫学会会誌, 30(6), pp.432-443; 2007
Abstract: 血管炎症候群においては,ANCAの発見によりその発症機序,病態が明らかにされつつある.感染症などを契機としてTNFαなどの炎症性サイトカインが誘導され,それによって細胞膜表面に露出した細胞質内顆粒構成成分に結合したANCAは血管内皮細胞とも結合し,溶解酵素および活性酸素を放出して傷害することが明らかになっている.ANCAの産生についても細菌菌体成分との分子相同性が関与している可能性が示唆されている.治療については,The European Vasculitis Study Group (EUVAS)が積極的に臨床試験を実施し,ステロイド薬とシクロフォスファミドを中心とした免疫抑制薬の併用療法についての治療について確立している.さらに,生物学的製剤の投与についても有効であるとの報告が増えてきているが,有害事象の報告もみられ,その投与に当たっては注意が必要である. / Since antineutrophil cytoplasmic autoantibody (ANCA) was found, the researches in the pathogenesis of vasculitis syndrome have been developing. Proinflammatory cytokines including tumor necrosis factor-alpha are induced by certain infections, by which ANCA that binds to granule components of cytoplasm adhesions to endothelial cells. These endothelial cells produce proteolytic enzymes and oxygen radicals, which leads to vasculitis. It might be contributed in the production of ANCA that bacterial organisms are mimicry to the peptide sequences of granule components. The multicentric randomized clinical trials undertaken by the European Vasculitis Study Group (EUVAS) optimized that cyclophosphamide-corticosteroid combination therapy was useful to ANCA-associated vasculitis. It is increasing evidences that biologics are useful to ANCA-associated vasculitis, although it is necessary to take care of severe adverse effects.
Keywords: Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis / tumor necrosis factor (TNF)-α / infliximab / etanercept / rituximab
URI: http://hdl.handle.net/10069/23602
ISSN: 09114300
DOI: 10.2177/jsci.30.432
PubMed ID: 18174672
Rights: Copyright (c) 2007 日本臨床免疫学会
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/23602

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