自身免疫性风湿性疾病(AIRD)构成了一系列结缔组织疾病和功能障碍,类似于临床表现和自身抗体反应。AIRD治疗基于综合方法,主要目标是实现和获得疾病缓解,通过控制炎症。AIRD疗法具有较低的靶特异性,这通常会导致代谢紊乱,血脂异常和心血管风险增加。神经酰胺通过几种不同的途径参与炎症,其中许多有时相交。它们作为细胞凋亡的信号分子,改变免疫反应和驱动内皮功能障碍,并作为其他分子产生的调节剂,包括1-磷酸鞘氨醇(S1P)和1-磷酸神经酰胺(C1P)。AIRD病理中脂质代谢严重改变,一些研究表明,与对照组相比,风湿性疾病患者人体组织中神经酰胺的浓度和种类发生了变化。因此,许多体外和一些体内(动物)研究研究神经酰胺作为类风湿性关节炎(RA)治疗靶点的潜在用途,强直性脊柱炎,系统性红斑狼疮,纤维肌痛综合征,原发性干燥综合征,系统性硬化症,肌炎,全身性血管炎和银屑病关节炎。此外,大多数神经酰胺的合成是以饮食为中心的,因此,饮食干预可能会改变血液中神经酰胺的浓度并影响健康。随后,最近的几项临床试验评估了不同的饮食模式和营养素在人类中作为抗神经酰胺方案的可能性。营养是AIRD相关并发症的重要组成部分,本综述详细介绍了有关AIRDs患者神经酰胺水平的证据,抗神经酰胺治疗的结果,并讨论了在风湿性疾病中使用医学营养疗法作为补充抗神经酰胺治疗的可能性。
Autoimmune rheumatic diseases (AIRDs) constitute a set of connective tissue disorders and dysfunctions with akin clinical manifestations and autoantibody responses. AIRD treatment is based on a comprehensive approach, with the primary aim being achieving and attaining disease remission, through the control of inflammation. AIRD therapies have a low target specificity, and this usually propels metabolic disturbances, dyslipidemias and increased cardiovascular risk. Ceramides are implicated in inflammation through several different pathways, many of which sometimes intersect. They serve as signaling molecules for apoptosis, altering immune response and driving endothelial dysfunction and as regulators in the production of other molecules, including sphingosine 1-phosphate (S1P) and ceramide 1-phosphate (C1P). With lipid metabolism being severely altered in AIRD pathology, several studies show that the concentration and variety of ceramides in human tissues is altered in patients with rheumatic diseases compared to controls. As a result, many in vitro and some in vivo (animal) studies research the potential use of ceramides as therapeutic targets in rheumatoid arthritis (RA), ankylosing spondylitis, systemic lupus erythematosus, fibromyalgia syndrome, primary Sjögren\'s syndrome, systemic sclerosis, myositis, systemic vasculitis and psoriatic arthritis. Furthermore, the majority of ceramide synthesis is diet-centric and, as a result, dietary interventions may alter ceramide concentrations in the blood and affect health. Subsequently, more recently several clinical trials evaluated the possibility of distinct dietary patterns and nutrients to act as anti-ceramide regimes in humans. With nutrition being an important component of AIRD-related complications, the present review details the evidence regarding ceramide levels in patients with AIRDs, the results of anti-ceramide treatments and discusses the possibility of using medical nutritional therapy as a complementary anti-ceramide treatment in rheumatic disease.