eOCaAieaeEau

e?EIAIAIEA IOIOIIOII?I??
IUEUAI I UIUO?U IAI?OA
OOU?OIE–I?U O?E ·OIAAIE AA??AU
(O·AO? IEUA?UU??)
a.e. AIAI·A?O‚, A.C. OIOIIO‚
e?OUAOOO?
Ei aIOUEUUU ?A‚IUOIO„EE eAac, aOOI‚
?eciaiea ?iee oaeoi?a iae?ica iiooiee–aeuoa OII–? iiaaaeyei ?acaeoea aooieiioiiiai oaai?aoe-
I (OII–?) a iaoiaaiaca ainiaeeoaeuiuo ?aaiaoe?a- ieoa o iuoae [8].
neeo caaieaaaiee ?anoe?eei iaeanou i?eiaiaiey i?aia- Niaeanii aaiiui Sfikakis P. [9], e 2002 aiao aieaa
?aoia, iai?aaeaiiuo i?ioea OII–?. [1]. Naiue aieuoie 80 iaoeaioia AA ec 10 ?acee?iuo no?ai iieo?eee oa?a-
eeeie?aneee iiuo iaeiieai a ioiioaiee eioeeeneiaaa, ie? aioeoaeaie e OII–?. A iniiaiii yoi auee aaiiua,
i?aanoaaey?uaai niaie oeia?iua iiiieeiiaeuiua ai- iniiaaiiua ia i?eiaiaiee eioeeeneiaaa o iaaieuoiai
oeoaea e OII–? – iaiiio ec oaio?aeuiuo iaaeaoi?ia ?enea aieuiuo a e?aoein?i?iuo enneaaiaaieyo
ainiaeaiey i?e caaieaaaieyo ?aeiaaea [2]. A iineaaiea [10,11,12,13,14]. E oioy oeacuaaeinu, ?oi eioeeeneiaa
aiau iiyaeeenu naaaaiey, eana?ueany i?eiaiaiey ei- yooaeoeaai a eeeaeaaoee ii?oe anao i?iyaeaiee AA,
oeeeneiaaa ia oieuei i?e ?aaiaoieaiii a?o?eoa, aiee- aieuoeinoai enneaaiaaoaeae nin?aaioi?eee naia aieia-
eice?o?uai niiiaeeia?o?eoa, ini?eaoe?aneii a?o?eoa, iea ia eniieuciaaiee i?aia?aoa i?e aeaciie iaoieiaee,
aieacie Noeeea, ii e i?e a?oaeo ?aaiaoe?aneeo caaiea- eae iaeaieaa i?iaiinoe?anee iaaeaaii?eyoiii e oi?iea-
aaieyo, n?aae eioi?uo e aieaciu Aao?aoa (AA). iii i?eciaea AA (oaae. 1). Aieuoei ?eneii nianoaaiiuo
AA – o?iie?aneia ainiaeeoaeuiia caaieaaaiea, i?e iaae?aaiee ?aniieaaaao a?oiia aaoi?ia ec Aoei
eioi?ii ii?a?a?ony iiiaea i?aaiu. Ia?yao n oa?aeoa?- (A?aoey). Anee a 2001 a. Sfikakis P. e niaao. [15] i?iaiaeee
iie o?eaaie (?aoeaeae?o?uee aooiciue noiiaoeo, ycau iaiie?aoiua eioocee eioeeeneiaaa a aica 5 ia/ea iyoe
aaieoaeee e ii?a?aiea aeac) iaae?aa?ony e a?oaea iaoeaioai n ?aoeaeae?o?uei iaioaaeoii e i?e yoii io-
neiioiiu, oaeea eae o?iiaicu, oceiaaoay y?eoaia, ii- ia?aee auno?ia oiaiuoaiea ainiaeaiey aeaca a i?aaa-
?a?aiea ?aeoai?ii–eeoa?iiai o?aeoa, inaaaioieeeeo- eao ia?auo 24 ?ania, oi a 2003 a. yoe ?a aaoi?u [16] i?e-
eeou e a?oaea. N?aae auoaia?a?eneaiiuo iaeaieaa iaieee i?aia?ao o 24 aieuiuo AA; 18 ec ieo aaeaee aaoo-
na?uaciui yaeyaony oaai?aoeieo, eioi?ue aaaao e nie- e?aoiua eioocee eioeeeneiaaa e 6 – iaiie?aoiua. E
?aie?, a ni a?aiaiai – e iieiie iioa?a c?aiey [3]. Ii- aiiau a ia?aue aaiu oa?aiee eioeeeneiaaii oeene?i-
yoiio ea?aiea AA inoaaony iaiie ec nei?iuo i?iaeai aaeinu nouanoaaiiia iiauoaiea ino?iou c?aiey, oiaiu-
eeeie?aneie ?aaiaoieiaee. oaiea eiee?anoaa eeaoie e ia 50% auiioa a noaeeiaea-
Ia yoii naeaaoaeunoaoao iaaaaii iioaeeeiaaiiue iii oaea. A i?aaaeao iineaao?ueo aaoo iaaaeu ino?ia
Eio?aiianeee iaci? [4], aaa i?aanoaaeai aiaeec ?acoeu- ainiaeaiea aeaca ?ac?aoeeinu o aieuoeinoaa aieuiuo.
oaoia eniuoaiee i?aia?aoia o 679 iaoeaioia AA. Ioia- A oaaeeoa 1 naaaaiu iaeioi?ua aaiiua, eana?ue-
?aaony iaainoaoi?iay i?aaeaiinou e aieacaiiinou ?ac- any i?eiaiaiey eioeeeneiaaa ia iaiaa ?ai o o?ao
ee?iuo aeaia oa?aiee AA: n i?eiaiaieai eieoeoeia, aieuiuo AA.
oeeeioinoaieaa e ae?eiei?oeeieaia (AE) i?e ii?a?a- Falappone P. e niaao. [19] ioaieee yooaeoeaiinou o
iee aeac; acaoeii?eia e eieoeoeia i?e a?o?eoa; aoeeei- 3 aieuiuo oaaeoii, ?acenoaioiui e i?aaoanoao?uae
ae?a e eioa?oa?iia i?e noiiaoeoa. Iiaoaa??aaia yo- oa?aiee (AE eieaeuii e nenoaiii, iaoio?aenao, oee-
oaeoeaiinou acaoeii?eia e oeeeinii?eia i?e iaoieiaee einii?ei, noeuoanaeacei). Iiieii noaaeeecaoee i?i-
aeac e aaicaoei–iaieoeeeeia – i?e a?o?eoa. Aianoa n oanna, aaoi?u iia?a?eeaa?o aicii?iinou oiaiuoaiey
oai aey ieii?aoaeuiiai no?aaiey iaiaoiaeiu ?aiai- aicu oeeeinii?eia ia 30% e ioiaiu a?oaeo auoaia-
iece?iaaiiua ieaoaai–eiio?iee?oaiua aaieiua nea- caaiiuo i?aia?aoia.
Ni a?aiaiai noaiiaeony i?aaeaiui, ?oi iaiaoi-
iua enneaaiaaiey ii n?aaieoaeuiie yooaeoeaiinoe
aeii aieain?i?iia i?eiaiaiea eioeeeneiaaa o
?acee?iuo i?aia?aoia o aieuiuo AA.
aieuiuo n aeoeaiui oa?aieai caaieaaaiey. Gulli S. e
Yoeieiaey AA iaecaanoia, ii nia?aiaiiua i?aanoa-
aeaiey i iaaeaoi?ao ainiaeaiey iicaieeee iano?aaou niaao. [22] i?eaiayo iaae?aaiea ca 54–eaoiae aieuiie,
iaoiaaiaoe?aneo? ?ieu OII–? i?e AA, eiioaio?aoey aeeoaeuiinou aieacie o eioi?ie ninoaaeea 35 eao. O?a
eioi?iai ieacaeanu iiauoaiiie o iaoeaioia, iniaaiii iinea ia?aie eioocee eioeeeneiaaa (5 ia/ea) ninoiyiea
a aeoeaio? oaco aieacie [5]. aieuiie oeo?oeeinu, e 8 ai? ca?eee ycau aaieoaeee,
Iiauoaiea o?iaiy OII–? o iaae?aaaiuo iaoeai- en?ac noiiaoeo e a?o?eo. ?aoeieo iieiinou? ?ac?aoee-
oia AA iineo?eei iniiaaieai aey eniieuciaaiey iiii- ny e 10 ai?. Eioocee eioeeeneiaaa iiaoi?yeenu ia 2, 6,
eeiiaeuiuo aioeoae e OII–? i?e yoii caaieaaaiee [6]. 14, 22 iaaaeyo e aaeaa – ?a?ac ea?aua 8 iaaaeu. Iaino-
Iaeucy ia oiiiyioou e i?aaoanoao?uea ?aaiou yiii- ?aiee ei?ii–neecenouo, nonoaaiuo e aeaciuo i?iyaea-
neeo enneaaiaaoaeae, a eioi?uo OII–?, yaeyynu i?i- iee ca ana a?aiy aaaaaiey i?aia?aoa ia auei.
ainiaeeoaeuiui oeoieeiii, aucuaae oaaeo a yenia?e- Iia?iaii ioaieaaaony yooaeoeaiinou eioeeeneia-
iaioa o ?eaioiuo [7], oiaaa eae aaaaaiea aioeoae e aa a ?aaioa Wechsler A. e niaao. [17]. ?aou?ai aieuiui AA

532 13, 8, 2005
eOCaAieaeEau
n ?ao?aeoa?iui e oa?aiee iaioaaeoii eioeeeneiaa ia- ee iieo?aou acaoeii?ei (2 ia/ea) e AE aac eciaiaiee ai-
cia?aeny ii 5 ia/ea (iaeneiaeuiay aica 400 ia) ia 0–2–6 ce?iaie (ioiaiai eeou oeeeinii?ei). I?e ioaiea yooa-
iaaaea e aaeaa ea?aua 8 iaaaeu. A ?aaioa aaoaeuii iie- eoeaiinoe ?acoeuoaou ieacaeenu neaao?ueie: n?aaiaa
nuaaaony ii?a?aiea aeac, e, ?oi i?aanoaaeyaony iniaai- ?enei iaino?aiee oaaeoa a «ia?eia eioocee» auei ain-
ii aa?iui, aaoi?u aa?o aaoeieoe? iaioaaeoa (aieu- oiaa?ii iaiuoei ii n?aaiaie? n 6 ianyoaie ai iacia-
oeinoai enneaaiaaoaeae iieuco?ony oa?ieiii «oaaeo»). ?aiey eioeeeneiaaa (2,5±0,06 e 0,92±0,76 niioaaonoaai-
I?e ia?aaiai oaaeoa a i?ioann aiaeaea?ony ?aao?ea e ii). Ana iaino?aiey ia?ao 0–22 iaaaeyie auee neaauie
oeeea?iia oaei, i?e caaiai oaaeoa iaae?aaaony aaneoeeo e ia oooaoaee c?aiey. Iieiaeia iaino?aiee i?eoeanu ia
nao?aoee, i?aaiaua iae?icu nao?aoee, iaieeeeo e ioae 14 iaaae? e o 3 aieuiuo ia 22 iaaae?; 40 iaino?aiee ia-
iaeoeu. Ni?aoaiea ia?aaiaai e caaiaai oaaeoa ie?n ii- ae?aaeenu iinea 22 iaaaeu iaae?aaiey. Na?uaciuo ii-
?a?aiea noaeeiaeaiiai oaea ?anniao?eaaaony, eae iaio- ai?iuo yooaeoia ia oa?aiee eioeeeneiaaii ia auei. A
aaeo. Oieoeeaoey iiiyoee a ioaiea aeaciie iaoieiaee caee??aiea aaoi?u oeacuaa?o, ?oi eioeeeneiaa yooa-
i?aanoaaeyaony iai iaiaoiaeiie i?e niiinoaaeaiee eoeaai a ea?aiee ?acenoaioiiai oaaeoa i?e AA, nie?aao
yooaeoeaiinoe eioeeeneiaaa a ?aciuo enneaaiaaieyo (e oy?anou e ?anoioo iaino?aiee, ii ?aienne? iaania?eaaao
i?eia?o, ecaanoiue yiiineee iooaeuiieia Ohno S. [3] oieuei o 31% aieuiuo. Iineieueo iaino?aiey oaaeoa ia-
i?eiaiyao oa?iei «oaai?aoeieo»). ae?aaeenu a iniiaiii a eiioa 8–iaaaeuiiai eioa?aaea,
Niaeanii aaiiui Wechsler A. e niaao. [17] eioeee- aaoi?u iieaaa?o, ?oi a?aiy ia?ao eiooceyie aie?ii
neiaa ieacaeny yooaeoeaiui o anao aieuiuo n ia- auou oiaiuoaii.
ioaaeoii: iiauneeanu ino?ioa c?aiey, nieceeanu ae- Ia?yao n oaeeie ?anouie inei?iaieyie i?e AA, eae
eaoa?aeoa, iaeoeiiaoey, ao?ioey c?eoaeuiiai ia?aa,
oeaiinou i?ioanna, eioi?ay ?aiaa nio?aiyeanu a oa?aiea
caaiea neiaoee [23], o ?anoe aieuiuo ?acaeaaaony ia-
48–96 ianyoaa. N?iee iaae?aaiey a n?aaiai ninoaaeee
iaaneoey?ecaoey nao?aoee, ioya?a?uay c?eoaeuiue
15 ianyoaa, e anee eiaee ianoi iaino?aiey, oi iie au-
i?iaiic. Eiaiii yoi inei?iaiea iieo?eei ia?aoiia
ee ?anoaiaiu eae neaaua. Oaaeinu nieceou aico i?aaie-
?acaeoea o 50–eaoiaai aieuiiai AA ?a?ac 8 ianyoaa ea-
cieiia n 45 ai 11 ia/noo. Yoa ?aaioa eioa?ania aua e a
?aiey eioeeeneiaaii [24].
iaoiae?aneii ieaia: aieuiui ai iacia?aiey eioeee-
Eae neaaoao ec i?eaaaaiiuo auoa aaiiuo, ai anao
neiaaa i?iaiaeeanu ioeun–oa?aiey iaoeei?aaieciei-
enneaaiaaieyo i?eiaiyaony iaia e oa?a aice?iaea ei-
iii (ii 1 a 3 aiy aioo?eaaiii), a ii ieii?aiee eioocee
oeeeneiaaa, o.a. 5 ia/ea. Eeou a iaiie ?aaioa yiiineeo
aiaaaeyeny iaoio?aenao a aica 7,5 ia a iaaae? (aic-
aaoi?ia Ohno S. e niaao. [3] i?eaiaeony niiinoaaeaiea
ii?ii, ii aiaeiaee n ?aaiaoieaiui a?o?eoii).
aaoo aice?iaie eioeeeneiaaa – 5 ia/ea o 7 aieuiuo AA e
A enneaaiaaieyo Gul A. e niaao. [20] ioaiaii aeeyiea
10 ia/ea – o 6. Auai? aieaa aunieeo aice?iaie, aicii?ii,
eioeeeneiaaa ia ?anoioo ?aoeaeaia oaaeoa e i?iaiic a
aue iaoneiaeai oai, ?oi ?anoioa ii?a?aiey aeac a ?iiiee
ioiioaiee c?aiey o aieuiuo n ?acenoaioiie e a?oaie oa-
aunieay, ninoaaeyao 70% n?aae anao aieuiuo AA e 10% ec
?aiee aeaciie iaoieiaee. 13 aieuiuo AA eiaee 22 ?aoe-
ieo ia eiio?iee?oaony oa?aieae. Aaoi?u ia ioiaoeee ?ac-
aeaa iaioaaeoa eee aaneoeeoa nao?aoee a oa?aiea 6 iany-
ee?ee i?e eniieuciaaiee ?aciuo aic eioeeeneiaaa, ii
oaa ai i?eiaiaiey eioeeeneiaaa, iineaaiee iacia?aeny
n?eoa?o, ?oi i?aia?ao aie?ai iacia?aouny ii noaia 0–2–6
ii 5 ia/ea a 0–2–6 e 14 iaaaee. Ia?eia io 0 ai 22 iaaaee
iaaaee, a aaeaa ea?aua 8 iaaaeu a oa?aiea aiaa aey ain-
aaoi?u ii?aaaeeee, eae «ia?eia eioocee», io 25 ai 54
oe?aiey iieiie ?aiennee oaai?aoeieoa.
iaaaee – eae «ia?eia iaae?aaiee». Aieuiua i?iaie?a-

Oaaeeoa 1. Eeoa?aoo?iua naaaaiey ia eniieuciaaiee eioeeeneiaaa i?e aieacie Aao?aoa
,
, ,
– (n)
Sfikakis P. et al., ?ao?aeoa?iue iaioaaeo, Oeo?oaiea c?aiey o 5 aieuiuo,
0–2–6 iaaaee
2001, A?aoey [15] n=5 o 2 – ?aienney noiiaoeoa, o 1 – a?o?eoa
Sfikakis P. et al., Iaioaaeo, N ia?aiai aiy oa?aiee oaaee?aiea
0–3–4–6–8 iaaaee
2003, A?aoey [16] n=24 ino?iou c?aiey
O 2 aieuiuo – iao iaino?aiee oaaeoa a oa?aiea
Wechsler A. et al., ?ao?aeoa?iue iaioaaeo, 22 ianyoaa; o 1 iao iaino?aiee 7 ianyoaa;
0–2–6–8 iaaaee
2004, O?aioey [17] i=4 o 1 – ?a?ac 5 ian. e?aoeia?aiaiiia iaino?aiea
ia?aaiaai oaaeoa. Aica AE nie?aia.
Markomichelakis N. Oaaee?aiea ino?iou c?aiey n 0,41 ai 0,83
Oaaeo,
et al., 2004, 5 ia/ea Oeo?oaiea a oa?aiea 6 ianyoaa iinea iineaaiae
i=10
A?aoey [18] eioocee i?aia?aoa
Falappone P. et al., ?ao?aeoa?iue oaaeo, Iao ?aoeaeaia oaaeoa. Oiaiuoaia aica AE,
5 ia/ea
2004, Eoaeey [19] i=3, aieiou ai ioiaiu
Gul A. et al., 2004, ?acenoaioiue oaaeo, ?aienney o 31% aieuiuo, oiaiuoaiea
0–2–6–14 iaaaee
Oo?oey [20] n=13 oy?anoe e ?enea iaino?aiee oaaeoa n 2,5 ai 0,92
O 7 oiaiuoaiea ?enea iaino?aiee oaaeoa, oiaiuoaia
Accorinti M. et al., ?ao?aeoa?iue oaaeo,
12 ianyoaa aica AE. O 1 aieuiiai ioiaia eioeeeneiaaa
2004, Eoaeey [21] i=8
(ec–ca ooaa?eoeaca)
Ohno S. et al., ?acenoaioiue oaaeo, 5–10 ia/ea ?anoioa iaino?aiee oaaeoa oiaiuoeeanu n 3,96–3,79
2004, ?iiiey [3] i=13 0 2–6 10 iaaaee ai 0,98–0,16 ?ac a aia


533

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neeo enneaaiaaoaeae [3], eioeeeneiaa ii?ii n?eoaou
N?aae a?oaeo oy?aeuo i?iyaeaiee AA, i?e eioi?uo
i?aia?aoii auai?a o aieuiuo AA i?e ii?a?aiee aeac.
eiieuciaaeny eioeeeneiaa – ?aeoai?ii–eeoa?iua ia-
?ooaiey, ?anoioa eioi?uo aioiaeo ai 26%. Hassard P. e
aEUA?UU?
niaao. [11] i?eiaieee eioeeeneiaa o iaiiai aieuiiai AA
1. Kalden I. Emerging role of anti–tumor necrosis factor therapy in rheumatic diseases.
n ?aeoai?ii–eeoa?iuie neiioiiaie, eioi?ue iieo?ee 4
Arhtr. Res., 2002, 4 (Suppl.2), P.534–540.
aicu i?aia?aoa a oa?aiea 6–iany?iiai ia?eiaa. Ioia?a-
2. cOOIO‚ O.a. e?EIAIAIEA EIUIEIOEI· (IOIOIIOII?I?A IUEUAI I UIUO?U
ii auno?ia ?aa?anne?iaaiea ?aeoai?ii–eeoa?iuo e IAI?OA OOU?OIE–? ‚ ?A‚IUOIO„EE: IO‚?A UIU? E EAE. eUOO. IA. EU?II, 2004,
aiaeeoa?iuo i?eciaeia aieacie. Eieiiineiiey, auiie- 20, 1123–1127.
iaiiay ?a?ac 10 iaaaeu iinea ia?aiai aeeaaiey i?aia?a- 3. Ohno S, Nakamura S, Hori S, Shimakawa M, Kawashima H, Mochizuki M., Sugita S,
Ueno S, Yoshizaki K, Inaba G. Efficacy, safety, and pharmacokinetics of multiple admin-
oa, iieacaea yiaineiie?aneia e aenoieiae?aneia oeo?oa-
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iea. Iineaaiaa nio?aiyeinu i?e iieiie ioiaia AE. Aaoi-
Jul;31(7): 1362–8.
?u iia?a?eeaa?o yooaeoeaiinou eioeeeneiaaa ia 4. Saenz A, Ausejo M, Shea B, Wells G, Welch V, Tugwell P. Pharmacotherapy for
eeoa?iua e aiaeeoa?iua i?iyaeaiey aieacie. Behcet’s syndrome (Cochrane Review). From The Cochrane Library, Issue 2, 2004.
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cell regulatory cytokines IL–10 and IL–12 in Behcet’s disease, soluble TNFR–75 as a bio-
iua i 2 iaoeaioeao n AA (27 e 30 eao), eioi?ui aue iacia-
logic marker of disease activity. J Rheumatol 1997, 24:128–132.
?ai eioeeeneiaa a aica 5 ia/ea – iaiie e 3 ia/ea – a?oaie.
6. Misumi M, Hagiwara E, Takeno M, Takeda Y, Inoue Y, Tsuji T, Ueda A, Nakamura S,
I?iyaeaiey aieacie o iaiie aieuiie aee??aee ycau aa- Ohno S, Ishigatsubo Y. Cytokine production profile in patients with Behcet’s disease
ieoaeee, noiiaoeo, aeiaiiaiaiua aunuiaiey ei?e, neii- treated with infliximab. Cytokine. 2003 Dec 7; 24(5):210–8.
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in the induction of experimental autoimmune uveoretinitis in mice.
ea o?iiaioeaaeo, aeaeoaeuiue aaneoeeo, ia?eaiaeuiua
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ieaa o iaiie, i?aaiecieiia, eieoeoeia e oeeeinii?eia – imental autoimmune uveoretinitis in mice by inhibiting antigen priming.
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eeoa?ieea, i?ae?aoeeanu aea?ay, en?acee aiaeeoa?iua
10. Goossens P., Verburg R., Breedveld F.: Remission of Behcet’s syndrome with tumour
i?iyaeaiey. Iiaoi?iia aeeaaiea eioeeeneiaaa ia?aie
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iieo?aea ieceo? aico oaeeaiieaa; noaaeeecaoey caaiea- clonal antibody therapy for gastrointestinal Behcet’s disease: a case report.
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syndrome with infliximab. Rheumatology (Oxford) 2001,40:473–474.
12 iaaaeu i?iaaaaia i?a?aaiay eioocey eioeeeneiaaa.
13. Rosembaum M., Rosner I., Porting E., Remission of Behcet’s syndrome with TNF?
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