{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:29:53Z","timestamp":1792301393547,"version":"4.4.0"},"reference-count":14,"publisher":"Akademiai Kiado Zrt.","issue":"29","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,7,1]]},"abstract":"<jats:p>A szerz\u0151k \u00f6sszefoglal\u00f3 k\u00f6zlem\u00e9ny\u00fckben az irodalmi adatok figyelembev\u00e9tel\u00e9vel \u00e1ttekintik a rheumatoid arthritis primer \u00e9s szekunder pulmonalis sz\u00f6v\u0151dm\u00e9nyeit. A rheumatoid arthritis gy\u00f3gyszeres ter\u00e1pi\u00e1j\u00e1nak pulmonol\u00f3giai sz\u00f6v\u0151dm\u00e9nyei k\u00f6z\u00fcl kiemelik a betegs\u00e9gm\u00f3dos\u00edt\u00f3 antireumatikus szereket, amelyek k\u00f6z\u00fcl kit\u00e9rnek a methotrexat induk\u00e1lta t\u00fcd\u0151gy\u00f3gy\u00e1szati k\u00f3rk\u00e9pekre. A methotrexat szinte majdnem minden addit\u00edv hat\u00e1s\u00fa kett\u0151s \u00e9s h\u00e1rmas \u2013 O\u2019Dell-s\u00e9ma \u2013 kombin\u00e1ci\u00f3s ter\u00e1pi\u00e1ban szerepel, ez\u00e9rt is fontos e gy\u00f3gyszer okozta pulmonalis sz\u00f6v\u0151dm\u00e9nyek id\u0151ben t\u00f6rt\u00e9n\u0151 felismer\u00e9se. A reumatol\u00f3gusok sz\u00e1m\u00e1ra egyre nagyobb kih\u00edv\u00e1st jelent a methotrexattal szemben rezisztens rheumatoid arthritis kezel\u00e9se. A biol\u00f3giai ter\u00e1pi\u00e1s szerek citokinantagonistak\u00e9nt, TNF-\u03b1-blokkol\u00e1s r\u00e9v\u00e9n fejtik ki hat\u00e1sukat, \u00e9s a betegs\u00e9gm\u00f3dos\u00edt\u00f3 antireumatikus szerekhez k\u00e9pest hat\u00e1sosabban tudj\u00e1k f\u00e9kezni a betegs\u00e9g progresszi\u00f3j\u00e1t. Ezek a biol\u00f3giai v\u00e1laszm\u00f3dos\u00edt\u00f3 szerek. F\u0151bb k\u00e9pvisel\u0151ik az infliximab, az adalimumab \u00e9s az etanercept. A szerz\u0151k v\u00e9g\u00fcl foglalkoznak a biol\u00f3giai v\u00e1laszm\u00f3dos\u00edt\u00f3 szerek okozta szekunder pulmonalis sz\u00f6v\u0151dm\u00e9nyekkel: a pulmonalis tuberculosissal, a bakteri\u00e1lis tracheobronchitisszel, a bakteri\u00e1lis pneumoni\u00e1val, bronchiectasi\u00e1val \u00e9s pulmonalis oedem\u00e1val, a rapid progressz\u00edv fibrotiz\u00e1l\u00f3 alveolitisszel, valamint a coccidiomycosissal. Az Arizona, Kalifornia, Nevada ter\u00fclet\u00e9n \u00e9l\u0151, biol\u00f3giai v\u00e1laszm\u00f3dos\u00edt\u00f3 szerekkel v\u00e9gzett ter\u00e1pi\u00e1ban r\u00e9szes\u00fcl\u0151 rheumatoid arthritises betegek mintegy 3%-\u00e1n\u00e1l v\u00e1rhat\u00f3 a 15%-os hal\u00e1loz\u00e1ssal j\u00e1r\u00f3 pulmonalis \u00e9s sziszt\u00e9m\u00e1s gombafert\u0151z\u00e9s \u2013 coccidiomycosis \u2013 kialakul\u00e1sa. A gyakori f\u00f6ldreng\u00e9sek k\u00f6vetkezt\u00e9ben a talajb\u00f3l a l\u00e9gt\u00e9rbe ker\u00fcl\u0151 sp\u00f3r\u00e1k beteg\u00edtik meg a gy\u00f3gyszeres ter\u00e1pia miatt immunszupprim\u00e1lt egy\u00e9neket. A szerz\u0151k felh\u00edvj\u00e1k a figyelmet, hogy az el\u0151bb eml\u00edtett end\u00e9mi\u00e1s, valamint egy\u00e9b f\u00f6ldreng\u00e9sakt\u00edv ter\u00fcletre utaz\u00f3, biol\u00f3giai ter\u00e1pi\u00e1ban r\u00e9szes\u00fcl\u0151 betegek potenci\u00e1lis fert\u0151z\u00e9svesz\u00e9lynek vannak kit\u00e9ve, amely miatt a betegek ez ir\u00e1ny\u00fa t\u00e1j\u00e9koztat\u00e1sa a kezel\u0151orvos r\u00e9sz\u00e9r\u0151l elengedhetetlen. A biol\u00f3giai v\u00e1laszm\u00f3dos\u00edt\u00f3 szerek \u00fajabb \u00e9s \u00fajabb csoportjainak kipr\u00f3b\u00e1l\u00e1sa \u00e9s felhaszn\u00e1l\u00e1sa a k\u00f6zelj\u00f6v\u0151ben v\u00e1rhat\u00f3 rheumatoid arthritisben. Jelenleg a TNF-\u03b1-g\u00e1tl\u00f3 kezel\u00e9sre nem reag\u00e1l\u00f3 betegekn\u00e9l lehet\u0151s\u00e9g van a non-Hodgkin-lymphoma ter\u00e1pi\u00e1j\u00e1ban haszn\u00e1latos B-lymphocyta-g\u00e1tl\u00f3 rituximab alkalmaz\u00e1s\u00e1ra. Ez ut\u00f3bbi citokin rheumatoid arthritisben t\u00f6rt\u00e9n\u0151 felhaszn\u00e1l\u00e1sa sor\u00e1n \u00e9szlelt pulmonalis sz\u00f6v\u0151dm\u00e9nyeir\u0151l m\u00e9g nem rendelkez\u00fcnk elegend\u0151 ismerettel. Napjaink antireumatikus ter\u00e1pi\u00e1i a betegek \u00e9letmin\u0151s\u00e9g\u00e9nek jelent\u0151s javul\u00e1s\u00e1t eredm\u00e9nyezik, mik\u00f6zben az egyre korszer\u0171bb kezel\u00e9si m\u00f3dok a pulmonalis sz\u00f6v\u0151dm\u00e9nyek k\u00f6r\u00e9t gyarap\u00edtj\u00e1k.<\/jats:p>","DOI":"10.1556\/oh.2008.28385","type":"journal-article","created":{"date-parts":[[2008,7,10]],"date-time":"2008-07-10T12:48:46Z","timestamp":1215694126000},"page":"1355-1361","source":"Crossref","is-referenced-by-count":1,"title":["The pulmonological manifestations of rheumatoid arthritis"],"prefix":"10.1556","volume":"149","author":[{"given":"Gy\u00f6rgy","family":"Bernscherer","sequence":"first","affiliation":[{"name":"1 Bernscherer \u00e9s Tsa Bt. Budapest"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Karab\u00e9lyos","sequence":"additional","affiliation":[{"name":"2 Biotest Hungaria Kft. 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