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Stellenwert von interleukingerichteten Therapien bei Autoimmunkrankheiten

Importance of interleukin-directed treatment for autoimmune diseases

  • Leitthema
  • Published:
Der Nephrologe Aims and scope

Zusammenfassung

Das Verständnis der Pathophysiologie von Autoimmunerkrankungen ermöglicht die Identifikation neuer Angriffspunkte für präzisere Pharmakotherapien. Diese sollen idealerweise neben einer hohen Effektivität auch ein besseres Sicherheitsprofil aufweisen. Interleukine (IL) sind eine Gruppe von Entzündungsmediatoren, die ganz unterschiedliche Autoimmun- und Autoinflammationserkrankungen in ihrem Verlauf beeinflussen können. Obwohl viele Biologika für die rheumatoide Arthritis entwickelt wurden, weitet sich ihr Einsatzgebiet mitunter auf andere Indikationen aus, wo sie teilweise sogar einen höheren Stellenwert haben, wie z. B. die IL-1-Antagonisten bei den Autoinflammationssyndromen. Mittlerweile therapieren wir mit Antikörpern gegen IL oder ihre Rezeptoren ein wachsendes Spektrum an Erkrankungen. Auch synthetische DMARD („disease modifying antirheumatic drugs“) sind im weitesten Sinne IL-gerichtete Therapien. Aus Gründen der Übersichtlichkeit soll es in diesem Artikel jedoch in erster Linie um Biologika, die unmittelbar IL hemmen, bzw. im Fall von IL‑2 um ein therapeutisch eingesetztes IL selbst gehen.

Abstract

Understanding the pathophysiology of autoimmune diseases enables the identification of new targets for more precise pharmacotherapies. Ideally, these should not only be highly effective but also have a better safety profile. Interleukins (IL) are a group of inflammatory mediators that can influence the course of very different autoimmune and autoinflammatory diseases. Although many biologicals have been developed for rheumatoid arthritis, their application has extended to other indications where they are even more important, e.g. IL‑1 antagonists in autoinflammatory syndromes. In the meantime, a growing spectrum of diseases are being treated with antibodies against IL or their receptors. Synthetic disease-modifying antirheumatic drugs (DMARD) are also IL-directed therapies in the broadest sense. For reasons of clarity, however, this article primarily addresses biologicals that directly inhibit IL or in the case of IL‑2 an IL which is itself used for treatment.

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  1. Abteilung für Nephrologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    A. Hammitzsch, U. Heemann &  P. Moog

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  1. A. Hammitzsch
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  2. U. Heemann
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  3. P. Moog
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Correspondence to P. Moog.

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A. Hammitzsch, U. Heemann und P. Moog geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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U. Heemann, München

U. Kunzendorf, Kiel

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Hammitzsch, A., Heemann, U. & Moog, P. Stellenwert von interleukingerichteten Therapien bei Autoimmunkrankheiten. Nephrologe 15, 95–104 (2020). https://doi.org/10.1007/s11560-020-00413-x

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