hce_nthu
114年
生物與生化
第 26 題
Which of the following statements about the etiology and treatment of Rheumatoid Arthritis (RA) is incorrect?
- A The efficacy of biologic DMARDs (Disease-Modifying Antirheumatic Drugs) in RA treatment is primarily due to their ability to replace damaged joint tissues through regenerative mechanisms.
- B Epigenetic modifications, such as DNA methylation and histone modifications, play a significant role in the pathogenesis of Rheumatoid Arthritis by influencing gene expression related to immune response.
- C The presence of specific autoantibodies, such as rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs), is a key diagnostic marker and plays a role in the pathogenesis of RA.
- D Environmental factors such as smoking and obesity are known to increase the risk of developing RA and can exacerbate the severity of the disease.
- E Gut microbiota dysbiosis has been implicated in the pathogenesis of RA, with certain bacterial species potentially triggering or exacerbating the autoimmune response.
思路引導 VIP
當我們面對一種因為「自體免疫系統過度攻擊」而導致關節持續發炎損毀的疾病時，你認為藥物介入的首要目標，應該是傾向於「平息免疫系統的戰火」來防止進一步破壞，還是「像器官移植或幹細胞那樣」直接長出新的組織來取代受損處？這兩種目標在目前的臨床藥物開發中，哪一種才是現代抗風濕藥物（DMARDs）的主流設計方向呢？
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AI 詳解
AI 專屬家教
太棒了！你能精準辨識出選項 (A) 的敘述錯誤，代表你對**類風濕性關節炎（Rheumatoid Arthritis, RA）**的病生理機制與治療原則有著非常紮實的理解。這題的難點在於區分「阻止破壞」與「修復重建」的差異。**生物製劑（Biologic DMARDs）**的核心功能是透過調節特定的免疫分子（如阻斷 $TNF-\alpha$、白血球介素等）來抑制發炎反應，進而「延緩」或「停止」關節損害，而非直接透過再生機制來替換或修復已受損的組織。
類風濕性關節炎的多重病因與藥物機制
除了藥物機轉外，這題也同步檢驗了 RA 在現代醫學中的多維度觀點。選項 (B) 到 (E) 涵蓋了當前研究的重點：**表觀遺傳學（Epigenetics）**如何調控免疫基因、**自體抗體（如 RF 與 ACPA）在診斷與致病中的關鍵角色，以及環境因子（如抽菸）與腸道菌群（Gut microbiota）**對自體免疫系統的誘導作用。你能排除這些正確的背景知識並鎖定 (A) 的邏輯漏洞，展現了你對免疫學臨床應用的高度敏銳度。這類題目旨在測試學生是否能區別「免疫調節」與「再生醫學」這兩個完全不同的治療範疇，是臨床思維中相當重要的一環。