Abstract:
INTRODUCTION:Despite the emergence of newer immunomodulating agents for systemic lupus erythematosus (SLE), a substantial proportion of patients still do not respond optimally. While the mechanisms for the differential responses to drug therapy are unclear, variation in drug exposure with the same dosing protocol related to pharmacogenetic and pharmacokinetic factors may contribute. This article discusses the use of therapeutic drug monitoring (TDM) to optimize therapies in SLE patients. Areas covered: Evidence on the relationship between blood levels and efficacy/toxicity of immuno-modulating drugs such as hydroxychloroquine (HCQ), mycophenolate mofetil (MMF) and the calcineurin inhibitors that are often used in SLE. Expert commentary: Current data suggest a correlation between exposure and efficacy of HCQ and MMF in SLE. The relationship between HCQ or MMF blood concentrations and their adverse effects requires further elucidation. The serum trough level of tacrolimus does not appear to correlate with clinical response in lupus nephritis but is associated with toxic effects. Owing to the paucity of data, the 'optimal' blood levels of these agents in SLE have yet to be determined by large population pharmacokinetic studies. Nevertheless, TDM enables early identification of non-adherence and over-exposure to these SLE medications so that dosing adjustment can be performed to minimize toxicities and wastage.
journal_name
Expert Rev Clin Immunoljournal_title
Expert review of clinical immunologyauthors
Mok CCdoi
10.1080/1744666X.2016.1212659subject
Has Abstractpub_date
2017-01-01 00:00:00pages
35-41issue
1eissn
1744-666Xissn
1744-8409journal_volume
13pub_type
杂志文章,评审abstract::Treatment of idiopathic membranous nephropathy (IMN) is controversial. However, two randomized controlled trials (RCTs) reported that treatment with steroids alternated with an alkylating agent achieved significantly more remissions and better renal survival at 10 years in comparison with untreated controls. Short-ter...
journal_title:Expert review of clinical immunology
pub_type: 评论,杂志文章
doi:10.1586/eci.12.89
更新日期:2013-01-01 00:00:00
abstract::Cancer patients may develop paraneoplastic neurological conditions associated with autoantibodies directed against neural or neuromuscular tissues. These syndromes are frequently manifested in advance of the cancer presentation by several months or years necessitating a detailed and expensive investigation to search f...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.901151
更新日期:2014-05-01 00:00:00
abstract::Atherosclerosis is the major cause of cardiovascular disease (CVD), which represents the major cause of death. During recent years, it has become clear that atherosclerosis is a chronic inflammatory condition where immunity could play an important role. Usually, it is when atherosclerotic plaques rupture that CVD foll...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2015.993970
更新日期:2015-02-01 00:00:00
abstract::Asthma is a chronic disease that affects millions of individuals living in the USA. Proper asthma management is essential for controlling asthma symptoms and exacerbations. In recent years, however, there has been increased recognition of individuals using complementary and alternative medicine (CAM) to treat asthma. ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.4.6.703
更新日期:2008-11-01 00:00:00
abstract::Introduction: Patients affected by Inborn Errors of Immunity (IEI) represent a potential group-at-risk in the current COVID-19 pandemic. Studies on large and small cohorts of IEI reported a huge variability clinical manifestations associated to SARS-Cov-2, ranging from asymptomatic, mild, moderate/severe to death. A g...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2021.1873767
更新日期:2021-01-15 00:00:00
abstract::Immunology, similar to other areas of clinical science, is a data-rich discipline that involves a great deal of interaction between healthcare professionals and their patients. The focus of this editorial is to review the challenges and opportunities for mobile healthcare applications within immunology. It is clear th...
journal_title:Expert review of clinical immunology
pub_type: 社论,评审
doi:10.1586/1744666X.2015.1010518
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Psoriasis is a complex disease in which the alteration of the IL-23/Th17 axis appears to be crucial for its pathogenic mechanisms, and anti-IL17 agents are rapidly becoming important therapeutic tools. Brodalumab, a fully human Chinese hamster ovary cell-derived immunoglobulin G2 (IgG2) anti-IL-17RA monocl...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2016.1246957
更新日期:2016-12-01 00:00:00
abstract::Introduction: Psoriasis is a chronic autoimmune skin disease with strong genetic background and environmental triggers. Patients with psoriasis and psoriatic arthritis are at greater risk of developing other chronic and potentially severe comorbidities, such as psoriatic arthritis, hyperlipidemia, type 2 diabetes mell...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2019.1700113
更新日期:2020-01-01 00:00:00
abstract::In cross-sectional studies, vitamin D deficiency is frequent in spondyloarthritic patients and associated with increased spondyloarthritis (SpA) activity and structural damage. Experimental studies also show that vitamin D interferes with molecular pathways critically involved in SpA, especially regarding entheseal in...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.972944
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Hypersensitivity pneumonitis (HP) is an immunologically induced lung disease that develops after inhalation of certain environmental antigens only in subjects with susceptibility to antigens. Therefore, both environmental and host immunological factors play important roles in the aetiology and pathogenesis...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2016.1182426
更新日期:2016-09-01 00:00:00
abstract::Lung fibrosis is a devastating disease that involves a variable degree of inflammation, alveolar epithelial injury, fibroblast hyperplasia and the deposition of extracellular matrix. Standard therapies that consist of corticosteroids and immunosuppressive agents offer little benefit and most patients experience a prog...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.2.1.87
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Janus kinase (JAK) inhibitors are emerging treatments in dermatology. Also known as JAKinibs, these agents target JAK-signal transducers and activators of transcription (JAK-STAT) pathway for intracellular signaling. Among the various immune-mediated inflammatory skin diseases that the JAK-STAT pathway pla...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2021.1828068
更新日期:2020-10-01 00:00:00
abstract::Hematopoietic stem cell transplantation (HSCT), both allogeneic and autologous, has become one of the hottest topics in clinical immunology. One of the main autoimmune diseases in which HSCT has been extensively tried during the last decade is multiple sclerosis (MS). A few original papers and many anecdotal reports h...
journal_title:Expert review of clinical immunology
pub_type:
doi:10.1586/eci.10.7
更新日期:2010-05-01 00:00:00
abstract::The past years have seen the publication of several studies on seronegative spondylarthritides (SpA) and cardiovascular risk as a result of new insights into the connection between inflammation and atherogenesis. Although the overall cardiovascular disease is a complex entity, chronic inflammation of SpA is known to c...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.875468
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:Psoriasis is a common, chronic, immune-mediated inflammatory disorder. The disease is associated with several co-morbidities including cardiovascular disease, metabolic syndrome, and psychiatric disorders. It is important to identify and treat these co-morbidities because they have a strongly negative effe...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2016.1213631
更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:The incidence of inflammatory bowel disease (IBD) has increased over the last 50 years. It is now recognized that several genetic defects can express an IBD-like phenotype at very early onset (<6 years). AREAS COVERED:The aim of this review was to update knowledge concerning the specificity of IBD at onse...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2016.1184571
更新日期:2016-09-01 00:00:00
abstract::Glucocorticoids are indispensable for the treatment of systemic inflammatory diseases such as rheumatoid arthritis (RA), though their beneficial effects have to be balanced with potential complications arising from high doses, prolonged use or dose splitting. A glucocorticoid formulation (modified-release prednisone) ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/eci.11.95
更新日期:2012-02-01 00:00:00
abstract::Evolving data have shown that the toll like receptors (TLRs) family of innate immune receptors has an important role in driving the activation and inhibition of pathogenic pathways involved in multiple sclerosis (MS). While developing clinical trials targeting MS by TLRs modulators are of considerable interest, severa...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.953061
更新日期:2014-10-01 00:00:00
abstract::Eosinophilic esophagitis (EoE) represents a prevalent chronic esophageal disorder. Since the condition was first described, its pathophysiology has been known to have an immune-allergic origin, but the high response rate to dietary therapies based on feeding patients exclusively with amino acid-based elemental formula...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.856263
更新日期:2014-01-01 00:00:00
abstract::Inflammatory bowel disease includes ulcerative colitis and Crohn's disease, which are both inflammatory disorders of the gastrointestinal tract. Both types of inflammatory bowel disease have a complex etiology, resulting from a genetically determined susceptibility interacting with environmental factors, including the...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2013.824245
更新日期:2013-08-01 00:00:00
abstract::During pregnancy and after delivery, the maternal thyroid gland faces several metabolic, hemodynamic and immunologic changes. In this article we first summarize the current knowledge on the physiologic adaptation of the healthy thyroid to pregnancy, including variations of thyroid-stimulating hormone and free thyroid ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/eci.11.42
更新日期:2011-09-01 00:00:00
abstract::Introduction: The majority of the patients with anti-neutrophil cytoplasmic autoantibody (ANCA) associated vasculitis (AAV) achieve remission with effective induction therapy. Therefore, prevention of relapses and avoiding long-term damage and treatment-related toxicity are major challenges.Areas covered: This review ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2020.1693260
更新日期:2019-12-01 00:00:00
abstract::The measuring tools for disease activity of rheumatoid arthritis have long been adapted for assessing the disease activity of psoriatic arthritis (PsA), particularly as regards peripheral arthritis. However, because of the multifactorial aspects and multiple domains of PsA, such as axial and peripheral joints, skin an...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.943663
更新日期:2014-09-01 00:00:00
abstract::Specific allergen immunotherapy has been practiced for allergic rhinoconjunctivitis for over 100 years and is the only treatment option that is disease modifying. In the USA, immunotherapy is usually administered via subcutaneous injection; this is the only route with a US FDA-approved formulation. There is growing in...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/eci.12.41
更新日期:2012-08-01 00:00:00
abstract::Probiotics have had many applications in the past few years, and inflammatory conditions of the GI tract--including chronic disorders such as inflammatory bowel disease (IBD)--have received the most attention by investigators. In fact, the experimental basis to expect clinical efficacy of probiotics in IBD is quite ro...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/eci.09.70
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Secondary immunodeficiency is becoming a greater medical concern as the usage of immunosuppressive and biological treatments has increased. Individuals with certain medical conditions, such as hematological malignancies, can also have secondary immunodeficiency. Immunoglobulin replacement therapy (IGRT), w...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2020.1788939
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Allergic diseases are among the most common diseases in humans. Besides allergen avoidance, allergen-specific immunotherapy is the only causative treatment option. During recent years, many innovations of this therapy have emerged. METHODS:Selective literature research in Medline and PubMed, under the inclu...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,meta分析,评审
doi:10.1586/eci.13.25
更新日期:2013-05-01 00:00:00
abstract::Evaluation of: Tseng CE, Buyon JP, Kim M et al. The effect of moderate-dose corticosteroids in preventing severe flares in patients with serologically active, but clinically stable, systemic lupus erythematosus: findings of a prospective, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 54, 3623-36...
journal_title:Expert review of clinical immunology
pub_type: 评论,杂志文章
doi:10.1586/1744666X.3.3.267
更新日期:2007-05-01 00:00:00
abstract:INTRODUCTION:Biological agents have transformed psoriasis treatment by selectively targeting immune signaling molecules involved in psoriasis pathogenesis. While biologics offer the most effective treatment of moderate to severe psoriasis, they are not without complications. Some patients treated with biologics have po...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2016.1202115
更新日期:2016-12-01 00:00:00
abstract::Several 'omics' sciences have been launched. The outstanding diversity of immune system components, together with the complexity of the regulatory pathways and network-type interactions, makes immunology a combinatorial science. Cancer immonomics is a branch of immunomics. The present cancer immunomics project aims at...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.3.5.807
更新日期:2007-09-01 00:00:00