Old and new therapeutic strategies in systemic sclerosis (Review).
Autor: | Bobeica C; Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Niculet E; Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Tatu AL; Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunarea de Jos' University, 800010 Galati, Romania.; Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania.; Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 800010 Galati, Romania., Craescu M; Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Vata D; Clinical Department, Faculty of Medicine and Pharmacy, 'Gr. T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania., Statescu L; Clinical Department, Faculty of Medicine and Pharmacy, 'Gr. T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania., Iancu AV; Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania.; Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunarea de Jos' University, 800010 Galati, Romania., Musat CL; Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Draganescu ML; Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Onisor C; Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Lungu M; Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Fotea S; Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Nechita A; Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800216 Galati, Romania., Stefanescu BI; Department of Clinical Surgery, Faculty of Medicine and Pharmacy, 'Gr. T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania., Gheuca-Solovastru L; Clinical Department, Faculty of Medicine and Pharmacy, 'Gr. T. Popa' University of Medicine and Pharmacy, 700115 Iași, Romania. |
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Jazyk: | angličtina |
Zdroj: | Experimental and therapeutic medicine [Exp Ther Med] 2022 Feb; Vol. 23 (2), pp. 134. Date of Electronic Publication: 2021 Dec 13. |
DOI: | 10.3892/etm.2021.11057 |
Abstrakt: | Systemic sclerosis (SSc) is a chronic inflammatory disease with autoimmune determinism having an incompletely known pathogenesis. Although not all links in the pathogenic chain are known, studies have shown that vasculopathy is the initial event and is followed by extensive fibrosis of the skin and internal organs. New therapeutic strategies have been developed in recent years, thanks to innovative research which has increased understanding of the disease mechanisms. No curative treatment for SSc is currently known. Therefore, the therapeutic target in SSc is its symptomatology. Peripheral vasculopathy can be improved by administering vasodilators. Endothelin receptor antagonists and 5-phosphodiesterase inhibitors have a double benefit, both on peripheral and on pulmonary vasculopathy. Several molecules with antifibrotic effects are currently available; however, further studies are needed to confirm their beneficial effects. Immunosuppressants manage to control the cutaneous and visceral fibrotic process, thereby remaining as first-line drugs in the treatment of SSc. Although biological therapy using rituximab and tocilizumab has shown promising results in pulmonary fibrosis, ongoing studies are needed to determine their exact impact. The authors have differing views on the triggering role of glucocorticoids and the benefits of angiotensin-converting enzyme inhibitors in renal scleroderma. Some aspects of this disease such as calcinosis and pruritus, asthenia, or joint and muscle damage, remain difficult to manage. Competing Interests: The authors declare that they have no competing interests. (Copyright: © Bobeica et al.) |
Databáze: | MEDLINE |
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