Abstract:
Autoimmune pancreatitis (AIP) is a rare disease. There are two distinct types of AIP: AIP type 1 (AIP-1), a pancreatic manifestation of a multi-organ disease linked to immunoglobulin (Ig)G4, and AIP type 2 (AIP-2), a pancreas-specific disease unrelated to IgG4. The usual course of treatment for AIP is oral corticosteroid medication. Rituximab has also been recommended for recurrent AIP-1 in order to initiate remission and provide ongoing treatment. Immunomodulators such as azathioprine are used to keep certain patients in remission. Evaluation also takes into account a number of pharmacological alternatives, including biologic drugs like anti-tumor necrosis factor therapy, a safe and efficient second-line treatment for AIP-2 relapse or steroid dependence. Corticosteroids and immunosuppressants, which are poorly tolerated due to considerable side effects, are being replaced by other biologic drugs, which may offer a beneficial therapeutic alternative.
摘要:
自身免疫性胰腺炎(AIP)是一种罕见疾病。有两种不同类型的AIP:AIP类型1(AIP-1),与免疫球蛋白(Ig)G4和AIP2型(AIP-2)相关的多器官疾病的胰腺表现,与IgG4无关的胰腺特异性疾病。AIP的通常治疗过程是口服皮质类固醇药物。利妥昔单抗也被推荐用于复发性AIP-1,以开始缓解并提供持续治疗。免疫调节剂如硫唑嘌呤用于使某些患者保持缓解。评估还考虑了一些药理学替代品,包括抗肿瘤坏死因子治疗等生物药物,AIP-2复发或类固醇依赖的安全有效的二线治疗。皮质类固醇和免疫抑制剂,由于相当大的副作用,耐受性差,正在被其他生物药物取代,这可能提供一个有益的治疗选择。