中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (6): 563-567.doi: 10.35541/cjd.20240253

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布鲁顿酪氨酸激酶抑制剂在慢性自发性荨麻疹治疗中的进展

邱里    肖汀   

  1. 中国医科大学附属第一医院皮肤科  卫健委免疫皮肤病学重点实验室  教育部免疫皮肤病学重点实验室  免疫性皮肤病诊治技术国家地方联合工程研究中心,沈阳  110001
  • 收稿日期:2024-05-13 修回日期:2024-06-11 发布日期:2025-06-03
  • 通讯作者: 肖汀 E-mail:cmuxt@126.com
  • 基金资助:
    国家自然科学基金(82373487)

Bruton′s tyrosine kinase inhibitors in the treatment of chronic spontaneous urticaria

Qiu Li, Xiao Ting    

  1. Department of Dermatology, the First Hospital of China Medical University, NHC Key Laboratory of Immunodermatology, Key Laboratory of Immunodermatology of Ministry of Education, National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases, Shenyang 110001, China 
  • Received:2024-05-13 Revised:2024-06-11 Published:2025-06-03
  • Contact: Xiao Ting E-mail:cmuxt@126.com
  • Supported by:
    National Natural Science Foundation of China(82373487)

摘要: 【摘要】 慢性自发性荨麻疹(CSU)是慢性荨麻疹中最常见的表型。目前二代H1抗组胺药和奥马珠单抗是CSU的主要治疗选择,但仍有相当多的CSU患者存在治疗抵抗。布鲁顿酪氨酸激酶(BTK)抑制剂通过抑制肥大细胞、嗜碱性粒细胞脱颗粒和B细胞产生抗体,在CSU的治疗中具有理论基础且有潜在获益。第一代BTK抑制剂主要用于治疗B细胞相关的恶性肿瘤,但因选择性不佳,不良反应风险较高。第二代BTK抑制剂remibrutinib对BTK具有极高的亲和力和选择性,显示出良好的药代动力学特征,在CSU中已完成Ⅱ期和Ⅲ期研究。第二代BTK抑制剂为增加剂量抗组胺药治疗应答不佳的CSU患者提供了一种新的治疗选择。本文综述BTK抑制剂的作用机制、药理特点和临床应用情况。

关键词: 慢性荨麻疹, 蛋白酪氨酸激酶类, 蛋白激酶抑制剂, 治疗, 药物相关性副作用和不良反应, 布鲁顿酪氨酸激酶抑制剂

Abstract: 【Abstract】 Chronic spontaneous urticaria (CSU) is the most common phenotype of chronic urticaria. To date, second-generation H1 antihistamines (sgAHs) and omalizumab are the main treatment options for CSU. However, a considerable number of CSU patients are resistant to these therapies. Bruton's tyrosine kinase (BTK) inhibitors inhibit the degranulation of mast cells and basophils, as well as the production of antibodies by B cells, possessing a theoretical basis and potential benefits in the treatment of CSU. First-generation BTK inhibitors have been approved for the treatment of B cell-related malignancies, but there is a high risk of adverse reactions due to their poor selectivity. The second-generation BTK inhibitor remibrutinib has high affinity and selectivity for BTK, exhibiting good pharmacokinetic profiles. Phase Ⅱ and Ⅲ clinical trials of remibrutinib for CSU have been completed. Second-generation BTK inhibitors offer a novel treatment option for patients with CSU who do not respond adequately to increased doses of sgAHs. This review summarizes the mechanism of action, pharmacological characteristics, and clinical application of BTK inhibitors.

Key words: Chronic urticaria, Protein-tyrosine kinases, Protein kinase inhibitors, Therapy, Drug-related side effects and adverse reactions, Bruton′s tyrosine kinase inhibitors

引用本文

邱里 肖汀. 布鲁顿酪氨酸激酶抑制剂在慢性自发性荨麻疹治疗中的进展[J]. 中华皮肤科杂志, 2025,58(6):563-567. doi:10.35541/cjd.20240253

Qiu Li, Xiao Ting . Bruton′s tyrosine kinase inhibitors in the treatment of chronic spontaneous urticaria[J]. Chinese Journal of Dermatology, 2025, 58(6): 563-567.doi:10.35541/cjd.20240253