Zusammenfassung
In der Pathogenese infektiöser und entzündlicher
Erkrankungen nimmt das proinflammatorische Zytokin TNFα eine
Schlüsselposition ein. Die Aufklärung seiner zentralen
Rolle in der Pathogenese von rheumatoider Arthritis, Spondyloarthritiden,
Uveitis, Psoriasis und bei chronisch entzündlichen Darmerkrankungen
hat zur Entwicklung von gegen TNFα gerichteten Therapien geführt,
bei denen eine Erkrankungs-modifizierende Wirksamkeit beobachtet
wird, die über diejenige früherer Therapieoptionen
hinausgehen kann.
Befunde über das Auftreten weiterer chronisch entzündlicher Autoimmunerkrankungen
bei Patienten, die bereits an einer solchen Erkrankung leiden, haben
zur Hypothese geführt, dass gemeinsame pathologische Prozesse
dieser Zytokin-Dysregulation zugrunde liegen könnten. Entsprechend
wurde der Begriff TRECID als Oberbegriff für TNFα-assoziierte
chronisch entzündliche Erkrankungen entwickelt.
Ärzte verschiedener Fachdisziplinen haben aufgrund dieser
Pathophysiologie in den letzten Jahren neue Therapieoptionen mit TNFα-Blockern
in ihr Behandlungskonzept integriert. Das TRECID-Konzept kann daher
als Modell für eine dynamische, Disziplin-übergreifende
Zusammenarbeit auf gemeinsamer pathophysiologischer Basis gelten.
Summary
The pro-inflammatory cytokine TNF alpha (TNF) has a key position
in the pathogenesis of various infectious and inflammatory diseases.
Clarification of its pivotal role in the pathogenesis of rheumatoid
arthritis, spondyloarthritis, uveitis, psoriasis and inflammatory
bowel disease has resulted in the successful development of TNF-
blocking therapies, which have disease-modifying properties that
exceed the effects of conventional therapeutic options.
For this reason data on the concurrence of several chronic inflammatory
diseases have led to the hypothesis of common pathogenetic processes
of cytokine dysregulation. The acronym TRECID describes this concept
of „TNF RElated Chronic Inflammatory Diseases”.
Physicians of different specialties have integrated new therapeutic
options with TNF-blocking therapies into their strategies for the
management of the affected patients. Thus the concept of TRECID
can be regarded as a role model for a dynamic, interdisciplinary
cooperation based on shared pathophysiological aspects.
Schlüsselwörter
TRECID - TNFα - rheumatoide Arthritis - Spondyloarthritis - chronisch entzündliche Darmerkrankungen - Psoriasis - Psoriasisarthritis - Uveitis
Keywords
TRECID - TNFα - rheumatoid arthritis - ankyloarthritis - inflammatory bowel disease - psoriasis - psoriasis arthritis - uveitis
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Prof. Dr. Ulf Müller-Ladner
Lehrstuhl für Innere Medizin mit Schwerpunkt
Rheumatologie, Justus-Liebig Universität Giessen, Abt.
für Rheumatologie und Klinische Immunologie, Kerckhoff-Klinik
Benekestraße 2-8
61231 Bad Nauheim
Phone: 06032/9962101
Email: u.mueller-ladner@kerckhoff-klinik.de