„TRECID”: TNFα-assoziierte chronisch entzündliche Erkrankungen

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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