Systemische Autoimmunerkrankungen bei Kindern

Autoimmunerkrankungen bei Kindern und Jugendlichen können mit einer erheblichen Morbidität und Mortalität verbunden sein. Obgleich einzelne Autoimmunerkrankungen selten vorkommen, sind sie in der Gesamtheit häufig. Autoimmunerkrankungen bedeuten große diagnostische und therapeutische Herausforderungen. Bei der Therapie zeigt sich ein Trend weg von der breiten Immunsuppression und hin zu einer möglichst gezielten Immunmodulation.

Schlüsselwörter

Autoimmunität - Antikörper - Entzündung - Immunmodulation

• Literatur

• 1 Kamradt T, Mitchison NA. Tolerance and autoimmunity. N Engl J Med 2001; 344: 655-664
• 2 Pisetsky DS. Pathogenesis of autoimmune disease. Nat Rev Nephrol 2023; 19: 509-524
• 3 Soulas P, Woods A, Jaulhac B. et al. Autoantigen, innate immunity, and T cells cooperate to break B cell tolerance during bacterial infection. J Clin Invest 2005; 115: 2257-2267
• 4 Wucherpfennig KW. Mechanisms for the induction of autoimmunity by infectious agents. J Clin Invest 2001; 108: 1097-1104
• 5 De Luca F, Shoenfeld Y. The microbiome in autoimmune diseases. Clin Exp Immunol 2019; 195: 74-85
• 6 Arbuckle MR, McClain MT, Rubertone MV. et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N Engl J Med 2003; 349: 1526-1533
• 7 Conrad N, Misra S, Verbakel JY. et al. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet 2023; 401: 1878-1890
• 8 Pfeifer J, Thurner B, Kessel C. et al. Autoantibodies against interleukin-1 receptor antagonist in multisystem inflammatory syndrome in children: a multicentre, retrospective, cohort study. Lancet Rheumatol 2022; 4: e329-e337
• 9 Malleson PN, Mackinnon MJ, Sailer-Hoeck M. et al. Review for the generalist: The antinuclear antibody test in children – When to use it and what to do with a positive titer. Pediatr Rheumatol Online J 2010; 8: 27
• 10 von Mühlen CA, Garcia-De La Torre I, Infantino M. et al. How to report the antinuclear antibodies (anti-cell antibodies) test on HEp-2 cells: guidelines from the ICAP initiative. Immunol Res 2021; 69: 594-608
• 11 Brogan PA, Dillon MJ. Autoimmune diseases in children. Curr Paediatr 2005; 15: 23-31
• 12 Davidson A, Diamond B. Autoimmune diseases. N Engl J Med 2001; 345: 340-350
• 13 Martini A, Lovell DJ, Albani S. et al. Juvenile idiopathic arthritis. Nat Rev Dis Primers 2022; 8: 5
• 14 Hinze C, Wagner N, Tenbrock K. Kollagenosen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2018; 166: 562-571
• 15 Weiss PF. Pediatric vasculitis. Pediatr Clin North Am 2012; 59: 407-423
• 16 Buer JK. A history of the term “DMARD”. Inflammopharmacology 2015; 23: 163-171
• 17 Rao VK, Kulm E, Grossman J. et al. Long-term treatment with selective PI3Kdelta inhibitor leniolisib in adults with activated PI3Kdelta syndrome. Blood Adv 2024; 8: 3092-3108
• 18 Greco R, Alexander T, Del Papa N. et al. Innovative cellular therapies for autoimmune diseases: expert-based position statement and clinical practice recommendations from the EBMT practice harmonization and guidelines committee. EClinicalMedicine 2024; 69: 102476
• 19 Müller F, Taubmann J, Bucci L. et al. CD19 CAR T-Cell Therapy in Autoimmune Disease – A Case Series with Follow-up. N Engl J Med 2024; 390: 687-700
• 20 Ravelli A, Consolaro A, Horneff G. et al. Treating juvenile idiopathic arthritis to target: recommendations of an international task force. Ann Rheum Dis 2018; 77: 819-828