PDF(Pubmed)
Abstract：
Multiple myeloma and monoclonal gammopathy of undetermined significance are plasma cell dyscrasias characterized by monoclonal proliferation of pathological plasma cells with uncontrolled production of immunoglobulins. Autoimmune pathologies are conditions in which T and B lymphocytes develop a tendency to activate towards self-antigens in the absence of exogenous triggers. The aim of our review is to show the possible correlations between the two pathological aspects. Molecular studies have shown how different cytokines that either cause inflammation or control the immune system play a part in the growth of immunotolerance conditions that make it easier for the development of neoplastic malignancies. Uncontrolled immune activation resulting in chronic inflammation is also known to be at the basis of the evolution toward neoplastic pathologies, as well as multiple myeloma. Another point is the impact that myeloma-specific therapies have on the course of concomitant autoimmune diseases. Indeed, cases have been observed of patients suffering from multiple myeloma treated with daratumumab and bortezomib who also benefited from their autoimmune condition or patients under treatment with immunomodulators in which there has been an arising or worsening of autoimmunity conditions. The role of bone marrow transplantation in the course of concomitant autoimmune diseases remains under analysis.
摘要：
多发性骨髓瘤和意义不明的单克隆丙种球蛋白病是浆细胞异常，其特征是病理性浆细胞的单克隆增殖，免疫球蛋白的产生不受控制。自身免疫病理是其中T和B淋巴细胞在不存在外源性触发因素的情况下发展向自身抗原活化的趋势的病症。我们审查的目的是显示这两个病理方面之间可能的相关性。分子研究表明，引起炎症或控制免疫系统的不同细胞因子如何在免疫耐受条件的生长中起作用，从而使肿瘤性恶性肿瘤的发展更容易。导致慢性炎症的不受控制的免疫激活也被认为是肿瘤病理演变的基础。以及多发性骨髓瘤。另一点是骨髓瘤特异性疗法对伴随的自身免疫性疾病的过程的影响。的确,已观察到接受达雷妥单抗和硼替佐米治疗的多发性骨髓瘤患者也受益于自身免疫状况,或接受免疫调节剂治疗的患者自身免疫状况出现或恶化.骨髓移植在伴随自身免疫性疾病过程中的作用仍在分析中。
