RESUMO
Sarcoidosis is a chronic multisystem disease of unknown etiology, characterized by noncaseating granulomatous infiltration of virtually any organ system. Treatment is often undertaken in an attempt to resolve symptoms or prevent progression to organ failure. Previous studies have suggested a prominent role for tumor necrosis factor-alpha (TNF-alpha) in the inflammatory process seen in sarcoidosis. TNF-alpha and interleukin-1 are released by alveolar macrophages in patients with active lung disease. Corticosteroids have proved to be efficacious in the treatment of sarcoidosis, possibly by suppressing the production of TNF-alpha and other cytokines. Three agents are currently available as specific TNF antagonists: etanercept, infliximab, and adalimumab. Although data from noncomparative trials suggest that all three have comparable therapeutic effects in rheumatoid arthritis, their effects in a granulomatous disease such as sarcoidosis are less consistent. In this review, current data on the effectiveness are summarized.
Assuntos
Hipertensão Pulmonar/etiologia , Esclerodermia Difusa/complicações , Estresse Fisiológico/complicações , Tomada de Decisões , Humanos , Hipertensão Pulmonar/fisiopatologia , Hipertensão Pulmonar/psicologia , Pressão Propulsora Pulmonar , Fatores de Risco , Estresse Fisiológico/fisiopatologia , Estresse Fisiológico/psicologia , Resultado do TratamentoAssuntos
Conservadores da Densidade Óssea/uso terapêutico , Fraturas Ósseas/prevenção & controle , Compostos Organometálicos/uso terapêutico , Osteoporose Pós-Menopausa/tratamento farmacológico , Tiofenos/uso terapêutico , Feminino , Fraturas Ósseas/etiologia , Humanos , Osteoporose Pós-Menopausa/complicaçõesRESUMO
No disponible
Assuntos
Humanos , Fibromialgia/tratamento farmacológico , Agonistas de Dopamina/uso terapêutico , Estimulantes do Sistema Nervoso Central/antagonistas & inibidoresRESUMO
A possible role of tumor necrosis factor alpha (TNFalpha) in the pathomechanism of sarcoidosis must be considered in the analysis of this disorder since elevated concentrations of this cytokine have been found. In addition, TNFalpha expression could be demonstrated in sarcoid granulomata [1]. It is well known that TNFalpha plays a crucial role in granulomatous inflammation, e.g., in mycobacterial diseases [2]. Therefore, TNFalpha blockade is a potential approach in the therapy for sarcoidosis. Up to now, various cases of therapy-resistant sarcoidosis treated with anti-TNFalpha (infliximab and etanercept) have been reported [3-8]. Here, we describe successful treatment using adalimumab, a human recombinant immunoglobulin (Ig) G1 anti-TNF monoclonal antibody [9].
Assuntos
Anticorpos Monoclonais/uso terapêutico , Antirreumáticos/uso terapêutico , Sarcoidose/tratamento farmacológico , Adalimumab , Adulto , Negro ou Afro-Americano , Anticorpos Monoclonais Humanizados , Diabetes Mellitus Tipo 1/complicações , Resistência a Medicamentos , Humanos , Masculino , Sarcoidose/complicações , Resultado do Tratamento , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
No disponible
