强直性脊柱炎的发病机制与药物选择OA
Pathogenesis and drug selection in ankylosing spondylitis
强直性脊柱炎(ankylosing spondylitis,AS)累及骶髂关节与脊柱,多见于年轻男性,症状为腰背痛、晨僵、活动受限.病因受遗传、免疫失衡及肠道菌群多因素驱动.现药物治疗以非甾体类抗炎药(NSAIDs)、肿瘤坏死因子-α(TNF-α)抑制剂为主,辅以缓解病情抗风湿药(DMARDs)与糖皮质激素,但疗效与耐受性有限.本文综述发病机制,并附机制图,重点评述白细胞介素-17(IL-17)、IL-23/IL-12、JAK 抑制剂,以及成骨通路抑制剂、肠道调节剂及小分子药物的疗效与安全性,供新策略与临床应用参考.
Ankylosing spondylitis(AS)involves the sacroiliac joints and spine,and is more common in young men.Symptoms include lower back pain,morning stiffness,and limited mobility.The etiology is driven by multiple factors including genetics,immune imbalance,and gut microbiota.The current drug therapy mainly uses NSAIDs and TNF-α inhibi-tors,supplemented by DMARDs and glucocorticoids,but the efficacy and tolerability are limited.This article provides an o-verview of the pathogenesis and includes a mechanistic diagram,with a focus on the efficacy and safety of IL-17,IL-23/IL-12,JAK inhibitors,osteogenic pathway inhibitors,intestinal modulators,and small molecule drugs,for reference in new strategies and clinical applications.
成文静;刘义;许碧莲;李文德
广东医科大学热带与海洋医学学院,广东 湛江 524023广东医科大学热带与海洋医学学院,广东 湛江 524023广东医科大学热带与海洋医学学院,广东 湛江 524023广东省生物技术研究院<广东省实验动物监测中心>,广东 广州 510663
医药卫生
强直性脊柱炎免疫通路肠道调节剂综合发病机制治疗药物疗效与安全性
Ankylosing spondylitisImmune pathwaysIntestinal modulatorsComprehensive pathogenesisTherapeutic drugsEfficacy and safety
《药学研究》 2026 (4)
416-423,433,9
国家自然科学基金项目(No.32470567)广东省自然科学基金面上项目(No.2023A1515010470)广东省科技计划平台项目(No.2021B1212060002)广东省自然科学基金青年基金项目(No.2023A1515111103)广州市科技计划项目(No.2023B03J1257)
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