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Vol. 2. Núm. S3.
Esclerosis sistémica
Páginas S42-S45 (Noviembre 2006)
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Vol. 2. Núm. S3.
Esclerosis sistémica
Páginas S42-S45 (Noviembre 2006)
Esclerosis sistémica
Acceso a texto completo
Tratamiento de la esclerosis sistémica
Treatment of systemic sclerosis
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...
Gabriel Medrano Ramíreza, Olga Lidia Vera-Lastrab, Luis J. Jarac,
Autor para correspondencia
luis_jara_quezada@hotmail.com

Correspondencia: Dr. L.J. Jara. Jefe de la División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. Seris/Zaachila, s/n. Colonia La Raza. CP 02990 México DF. México.
a Departamento de Reumatología. Hospital General de México. SS. México DF. México
b Departamento de Medicina Interna. Universidad Nacional Autónoma de México. México DF. México
c Universidad Nacional Autónoma de México. División de Investigación. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico La Raza. IMSS. México DF. México
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Resumen

El tratamiento de la esclerosis sistémica se basa en 3 tipos de medicamentos modificadores de la enfermedad: fármacos que previenen el daño vascular, agents antifibróticos e inmunomoduladores e inmunodepresores. Los fármacos que previenen el daño vascular son: los antagonistas del calcio, los análogos de las prostaglandinas, los bloqueadores de los receptores de endotelina (bosentán), los inhibidores de la enzima de conversión de la angiotensina, los antagonistas de los receptores de la angiotensina y los inhibidores de la 5’-fosfodiesterasa, y han demostrado eficacia en el fenómeno de Raynaud, la crisis renal y la hipertensión arterial pulmonar. En contraste, los resultados del tratamiento de la fibrosis son poco alentadores y la D-penicilamina continúa siendo motivo de controversia. La terapia inmunodepresora con ciclofosfamida y el trasplante de células hematopoyéticas pueden ser beneficiosos. El conocimiento de la patogenia molecular de la esclerosis sistémica conducirá a nuevas estrategias de tratamiento.

Palabras clave:
Tratamiento
Esclerosis sistémica
Antagonistas de los receptores de la angiotensina
Antifibróticos
Inmunodepresores
Bosentán
Trasplante de células hematopoyéticas

Treatment of systemic sclerosis is based upon 3 types of medications modifiers of disease: drugs which prevent vascular damage, antifibrotric agents, and immunomodulators and immunosupressors. Drugs that prevent vascular damage such as: calcium antagonists, prostaglandins analogues, receptors of endothelin blockers (bosentan), inhibitors of angiotensin converting enzyme, receptors of angiotensin antagonists and inhibitors of 5’-phosphodiesterase have been successful in treating the Raynaud’s phenomenon, renal crisis and pulmonary arterial hypertension. In contrast, the results of treatment of fibrosis are discouraging and the D-penicilamine continues being a matter of controversy. The immunosupressor therapy with cyclophosphamide and the transplant of hematopoietic cells, may be beneficial. The knowledge of the pathogenesis of systemic sclerosis to molecular level will lead to new treatment strategies.

Key words:
Therapy
Systemic scherosis
Receptors of angiotesin antagonist
Antifibrotic agents
Immusupressors
Bosentan
Trasplant of hematopoietic cells
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Copyright © 2006. Elsevier España S.L. Barcelona
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