一项十年的研究可造福狼疮患者

Today, individuals with lupus（狼疮） nephritis（肾炎） benefit from better treatments than a decade ago, according to a review appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The article suggests that patients with the disease can now live full lives without suffering from many treatment-related side effects that plagued（困扰，折磨） them in the past. In the future, patients will likely experience additional benefits from treatment strategies currently being explored in clinical trials. Individuals with the autoimmune disease systemic lupus erythematosus（全身性红斑狼疮） (SLE) can experience a number of medical complications, such as lupus nephritis, an inflammatory kidney disorder¹. Lupus affects about 1.4 million persons in the US (particularly women aged² 20 to 40 years of age); it can be serious and lead to kidney failure. Researchers have been vigorously studying therapies for the condition in recent years and made significant advances that have helped affected³ individuals.

Gerald Appel, MD and Andrew Bomback, MD (Columbia University College of Physicians and Surgeons) recently reviewed the various breakthroughs in lupus nephritis research over the past 10 years. They note that improved classification of different classes of the condition now guide therapy. New treatment regimens（养生法，政体） use lower doses and shorter treatment durations of intravenous（静脉内的） cyclophosphamide（环磷酰胺） , a highly toxic⁴ immunosuppressive（免抑制力的） drug—a change that has reduced treatment-related side effects without sacrificing efficacy. In addition, the less toxic immunosuppressive agent mycophenolate mofetil has emerged as a viable⁵ alternative to cyclophosphamide for certain classes of lupus nephritis. Also, combination treatments with multiple agents have provided greater benefits than single drugs for many patients.

New therapies that target specific components⁶ of the immune system are also proving useful. For example, rituximab（利妥昔单抗） , an antibody that depletes⁷ B cells, may induce remissions in some patients with severe lupus nephritis, including those whose condition does not respond to cyclophosphamide or mycophenolate mofetil. Other targeted agents include ocrelizumab and belimumab, which also act on B cells, as well as abatacept, which blocks T cell activation⁸. Finally, recent clinical trials have shown that once a patient is in remission（缓解，宽恕） , mycophenolate mofetil and azathioprine are effective for preventing relapses.

"Treatment of lupus nephritis is rapidly changing, becoming safer and more effective," said Dr. Appel. Because the disease still negatively affects many individuals, though, investigators⁹ continue to seek out new therapies and new regimens based on old therapies. "The treatment of lupus nephritis today is markedly different, and objectively more effective, than it was 10 years ago. The hope and expectation is that a similar claim will be made 10 years hence（因此，今后） ," the authors wrote.