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    Home > Active Ingredient News > Immunology News > In the era of biological agents, where will the treatment of rheumatic immune diseases go?

    In the era of biological agents, where will the treatment of rheumatic immune diseases go?

    • Last Update: 2021-06-18
    • Source: Internet
    • Author: User
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    *Only for medical professionals to read and refer to the famous doctors talking about rheumatism.
    You are invited to taste the Twenty-Fifth National Rheumatology Academic Conference (CRA) of the Chinese Medical Association has come to a successful conclusion
    .

    Experts gathered at the conference to show their academic demeanor
    .

    At the conference site, we are fortunate to invite Professor Dongyi He from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine and Professor Dai Yu from Sun Yat-sen Memorial Hospital of Sun Yat-Sen University to the live broadcast room of "Famous Doctor Kung Fu Tea, Approaching CRA" to bring relevant cells to all colleagues.
    Introduction to cutting-edge research of factors and biological agents and insights from the conference
    .

    Professor He Dongyi: The rapid development of mechanism research promotes the progress of disease diagnosis and treatment.
    Professor He Dongyi’s interview video Moderator: What do you think is the current development status of rheumatism and immunology? In recent years, what achievements has my country made in advancing the development and construction of disciplines? Professor Dongyi He: Rheumatism has existed since ancient times, but it has only really begun to explain the pathogenesis and treatment mechanism of rheumatism in the past 100 years.
    Especially in the past 20 to 30 years, relevant research has progressed very fast
    .

    Now we have discovered many signaling pathways and cytokines that play a key role in rheumatic immune diseases, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-17, which not only reveal Their important mechanism of action in diseases has deepened our knowledge and understanding of diseases.
    Moreover, related drugs developed for these cytokines and signal pathways have also achieved good therapeutic effects in clinical practice, and have overcome difficulties for us.
    Symptoms bring hope
    .

     Moderator: Spondyloarthritis (SpA) is one of the hot topics of discussion at this conference, and the research progress on its pathogenesis has also been mentioned many times in the conference
    .

    What is your opinion on this, and can you share your opinion with us? Professor Dongyi He: Actually, this kind of disease (spondyloarthritis or ankylosing spondylitis) has long been recorded in our country in ancient times
    .

    In the past when drugs were scarce, our treatment options were very limited-we could only use common anti-inflammatory and analgesic drugs to relieve symptoms, or use hormones when patients had extra-articular manifestations such as iridocyclitis, uveitis, etc.
    Treatment
    .

    The situation in remote grassroots is even more severe.
    Many patients have not received timely and clear diagnosis.
    When they come to our hospital for treatment, they are often in the late stage of the disease.
    The condition is serious and the treatment is difficult
    .

    With the rapid progress of research, our understanding of diseases has been continuously improved in the past two to three decades, including the discovery of the genetic background, pathogenesis, key cytokines and therapeutic drugs of the disease, which has greatly improved the diagnosis rate and treatment level of the disease.

    .

    Now, we can find seronegative spondyloarthritis and radiology-negative axial spondyloarthritis through MRI, and standardized treatment can delay the disease progression in time in the early stage of the disease
    .

    Therefore, research on the pathogenesis of spondyloarthritis can prompt us to achieve early detection, early treatment and standardized follow-up of the disease, delay or inhibit the progress of imaging and structural damage, and improve the quality of life of patients
    .

     Moderator: At present, in the treatment of common rheumatic diseases, what are the opportunities and challenges faced by the application of biological agents? Please talk about your opinion
    .

    Professor Dongyi He: I believe that opportunities outweigh challenges
    .

    First, regardless of whether imported or domestically produced drugs, biological agents have achieved significant curative effects in clinical practice, allowing the level of disease treatment to achieve leapfrog development; second, with the support of national medical insurance policies, innovations such as biological agents have The price of medicines has dropped drastically, and more patients can afford the medicines and benefit from it
    .

    However, the challenge in the clinical application of biologics lies in standardizing the use of drugs.
    Drugs are a "double-edged sword", especially biologics, which bring significant effects and risk of adverse reactions.
    The prevalence of hepatitis B and tuberculosis in China High, when applying biological agents to these patients with underlying diseases, it is necessary to pay attention to pre-use screening, medication selection and standardized treatment
    .

    Professor Dai Yu: Cytokine therapy is very promising in the treatment of rheumatic immune diseases.
    Professor Dai Yu’s interview video host: Cytokines have been recognized as important mediators of inflammation and joint damage in rheumatic diseases such as ankylosing spondylitis.
    Inhibition can have a therapeutic effect on the disease
    .

    How do you see the role of cytokines in the pathogenesis of diseases? Professor Dai Xun: Since the outbreak of the new crown last year, cytokine storms have attracted the attention of the medical community.
    This is an area that rheumatologists are more familiar with, because cytokine storms can occur in many patients with rheumatic immune diseases
    .

    In addition to the disease itself, gene mutations, drug use, infections and tumorigenesis can all lead to the production of cytokine storms
    .

    Although the spectrum of cytokines caused by different causes is different, they all have a common feature, that is, a rapid increase in multiple cytokines, which in turn leads to corresponding clinical symptoms in patients, and even multiple organ failure in severe patients
    .

    So far, although everyone knows that cytokines play a very important role in pathophysiology, and theoretically, the targeted therapy for cytokines should have a good application prospect, but how to achieve correct and precise targeted therapy , More research is still needed
    .

    It is believed that for a long period of time in the future, the mechanism of cytokine action and its targeted therapy will still be a hot research direction for clinicians
    .

     Moderator: What do you think about the application of biologics targeting cytokines in rheumatic diseases? Prof.
    Dai Xun: Targeted cytokine therapy is the focus of everyone's attention in the field of rheumatism and immunology (especially in the field of inflammatory joint disease)
    .

    In the past few decades, due to the discovery of the core role of cytokines in the pathogenesis of diseases, clinical treatment methods have been enriched and the level of treatment has been continuously improved
    .

    Research on cytokines and their targeted therapies has not only promoted the understanding of disease pathogenesis, but also led to the transformation and development of clinical treatment methods, helping us to develop targeted drugs for specific cytokines
    .

    The emergence of these biological agents has a milestone significance for the treatment of rheumatic diseases
    .

     Moderator: Interleukin-17 (IL-17) is a cytokine that has been frequently mentioned in recent years.
    It has been found to play a key role in the pathogenesis of many diseases.
    Can you talk about the relevant research on IL-17 Is it progressing? Prof.
    Dai Xun: There are many members of the cytokine family.
    The IL-17 family is a relatively important cytokine family discovered in recent years.
    Among them, IL-17A is the most widely studied member of this family
    .

    IL-17A plays a very important role in the occurrence and development of spondyloarthritis, and it is also a research hotspot in the entire immunological field.
    For example, at this conference, we specially invited Professor Dong Chen from the immunology field to introduce his team’s IL-17 aspects.
    The latest research progress
    .

    In clinical treatment, IL-17A-targeted drugs have been on the market and have been in clinical use for more than a year.
    It can play a good effect in the treatment of patients with ankylosing spondylitis
    .

     Moderator: Do you have any suggestions for the application of biological agents in the treatment of rheumatic diseases? Professor Dai Xu: Because the cytokines that play an important role in the pathogenesis of different diseases are different
    .

    Therefore, for different rheumatic diseases, we should choose different biological agents.
    For example, IL-6 has an important role in the pathogenesis of rheumatoid arthritis, but has not been found to have an important role in ankylosing spondylitis, so we should target IL- 6 targeted biologics (IL-6 receptor antagonists) are often used to treat rheumatoid arthritis rather than ankylosing spondylitis
    .

    IL-17A plays a key role in the pathogenesis of psoriasis and ankylosing spondylitis, so IL-17A inhibitors are currently mainly used in the treatment of these two diseases
    .

    Clinicians can understand the pathogenesis of various rheumatic diseases from the mechanism of action of different cytokines, and understand the application characteristics of different biological agents, which helps them to select suitable targeted biological agents for patients in clinical practice.
    The concept of precision treatment
    .

    Expert Profile Professor Dongyi He, Deputy Dean of the Department of Rheumatology, Shanghai University of Traditional Chinese Medicine, Chief Physician, Ph.
    D.
    Supervisor, Deputy Director, Rheumatology Branch of the Chinese Integrative Medicine Association, Deputy Director, Rheumatism Branch of the Chinese Association of Chinese Medicine, Rheumatology Branch, Chinese Medical Doctor Association Member of the Standing Committee, Chinese Medical Association Rheumatology Branch (seventh to tenth) Member, Shanghai Medical Association Rheumatology Branch Chairman, Shanghai Traditional Chinese and Western Medicine Association Rheumatology Branch Chairman, Shanghai Traditional Chinese Medicine Association Rheumatology Branch Vice-chairman Enjoy the special state of the State Council Allowances, Shanghai’s leading talents have successively won honorary titles such as National Model Worker, National May 1st Labor Medal, Chinese Physician Award and other honorary titles.
    Visiting scholar of the University of Texas in the United States.
    In the past 10 years, he has undertaken more than 20 national, provincial and ministerial scientific research projects as the first person in charge.
    Presided over 3 general projects of the National Natural Science Foundation of China), received a total of more than 17 million yuan in scientific research funds, published more than 160 papers, with a total impact factor of 241.
    61.
    Professor Dai Xun, chief physician, doctoral supervisor, Director of Rheumatology Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong Chairman of the Rheumatology Branch of the Provincial Medical Association Guangdong Provincial Medical Association Chairman of the Guangdong-Hong Kong-Macao Greater Bay Area Rheumatology Union Chairman of the Chinese Medical Association Rheumatology Branch Standing Committee Member of the Chinese Medical Association Rheumatology Branch Standing Committee Member of the Rheumatology Branch of the Chinese Medical Association Postdoctoral University of Pennsylvania School of Medicine A total of 226 papers have been published in more than 20 provincial and ministerial scientific research projects, including doctoral programs in universities and colleges of the Ministry of Education, among which 56 SCI papers have been published in journals such as Arthritis Rheumatol, J Autoimmun, Rheumatology (Oxford), Front Immunol, etc.
    The author or corresponding author has 26 articles, with an impact factor of 5 or more and 6 articles) This article is only used to provide scientific information to medical and health professionals, and does not represent the position of the platform
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