摘 要

        補體活化與多種常見的風濕性疾病相關，例如係統性紅斑狼瘡(SLE)，類風濕關節炎(RA)，和係統性血管炎。

        補體激活與這些疾病相關的證據包括在這些疾病患者以及實驗動物的受累組織中有補體沉積，補體蛋白水平降低，血和/或滑液中補體活化片段水平升高。

        Eculizumab，一種抑製補體C5的單克隆抗體，目前已經批準用於一些少見情況的治療，包括補體過度活化，這種治療的成功已經引起在風濕實踐中應用補體抑製治療的新興趣，特別是對係統性紅斑狼瘡。例如，抑製C5是減少狼瘡腎炎的腎小球炎症或治療血栓性微血管病的潛在方法。

        補體係統是複雜性疾病例如SLE導致組織損傷的眾多因素之一，確定補體激活在疾病中發揮主要作用具有一定的挑戰性。RA的另一個困難是在已有的各種治療模式下，確定治療性補體抑製的作用。在本篇綜述中，對風濕病治療中抑製補體治療潛力的證據進行了評價。

        原 文

        Abstract

        Complement activation is associated withcommon rheumatic diseases such as systemic lupus erythematosus(SLE),rheumatoid arthritis(RA) and systemic vasculitis. Evidence linkingcomplement activation to these diseases includes the presence of complementdeposition in affected tissues, decreased levels of complement proteins andhigh levels of complement activation fragments in the blood and/or synovialfluid of patients with these diseases, as well as data from experimentalmodels. Eculizumab, a monoclonal antibody that inhibits the complementcomponent C5, is now approved for the treatment of rare conditions involvingcomplement hyperactivation, and the success of this therapy has renewedinterest in understanding the utility of complement inhibition in rheumatologicalpractice, particularly for SLE. For example, inhibiting C5 is a potential meansof reducing glomerular inflammation in lupus nephritis or treating thromboticmicroangiopathy in SLE. The complement system is one of multiple mediators oftissue injury in complex diseases such as SLE, and identifying the diseasecontext in which complement activation has a predominant role is a challenge.An added difficulty in RA is identifying a role for therapeutic complementinhibition within the diverse treatment modalities already available. In thisReview, evidence for the therapeutic potential of complement manipulation inrheumatology practice is evaluated.

        引自：Trouw LA,Pickering MC,Blom AM.The complement system as a potential therapeutic target in rheumaticdisease. Nat Rev Rheumatol.2017 Aug 10.doi: 10.1038/nrrheum.2017.125. [Epub ahead of print]