Der Nephrologe

, Volume 2, Issue 1, pp 33–36

Lupusnephritis

Neue therapeutische Ansätze
Leitthema
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Zusammenfassung

Der systemische Lupus erythematodes (SLE) ist eine schubweise verlaufende, chronisch-entzündliche Autoimmunerkrankung mit Befall nahezu jedes Organsystems. Noch vor einigen Jahrzehnten galt der SLE als in der Regel sehr schwer verlaufend und oft letal endend. Während noch 1955 die 10-Jahres-Überlebenszeit nur 5% betrug, konnte durch die Einführung der immunologischen Diagnostik und der immunsuppressiven Therapie eine Verbesserung der 10-Jahres-Überlebensrate auf über 90% erreicht werden. Der wichtigste prognostische Faktor scheint das Ansprechen auf die Therapie nach den ersten 6 Monaten zu sein. Dies bedeutet, dass in der Frühphase der Erkrankung/Therapie die entscheidenden Weichen gestellt werden. Die Vielzahl der exemplarisch angeführten therapeutischen Optionen reflektiert die pathophysiologische Komplexität der Lupuserkrankung. Eine kausale Therapie des SLE existiert bislang noch nicht. Ziel der gegenwärtigen therapeutischen Bemühungen ist der Einsatz spezifischer und damit nebenwirkungsärmerer Immunsuppressiva und Immunmodulatoren.

Schlüsselwörter

Systemischer Lupus erythematodes Therapie Prognose Immunsuppressiva Immunmodulatoren 

Lupus nephritis

New therapeutic directions

Abstract

Systemic lupus erythematosus (SLE) is a stepwise, progressive, chronic inflammatory autoimmune disease which effects almost every organ system. Only a few decades ago, SLE was considered to usually follow a severe course that often ended fatally. While in 1955 the 10 year survival rate was only 5%, the introduction of immunological diagnostics and immunosuppressive therapy has led to an improvement to over 90% survival. The most important prognostic factor seems to be the response to therapy after the first 6 months. This means that the early phase of the disease/therapy is critical. The multiplicity of highly suitable therapeutic options reflects the pathophysiological complexity of SLE. A causal therapy does not exist at present. The aim of the current therapeutic effort is the use of specific immunosupressives and immunomodulators leading to fewer side effects.

Keywords

Systemic lupus erythematosus Therapy Prognosis Immunosuppressives Immunomodulators 

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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.I. Medizinische Klinik und Poliklinik, Rheumazentrum Rheinland-PfalzJohannes Gutenberg-Universität MainzMainzDeutschland

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