中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (6): 556-561.doi: 10.12007/j.issn.0258‐4646.2018.06.017

• 论著 • 上一篇    下一篇

血清TNF-α、IL-1β、IL-6和IL-17表达水平在阿达木单抗治疗活动性类风湿关节炎中的疗效预测作用

范晓蕾1, 刘中华2, 岳涛1, 何东仪1   

  1. 1. 上海市光华中西医结合医院关节内科, 上海 200052;
    2. 复旦大学附属中山医院肾内科, 上海 200032
  • 收稿日期:2017-06-09 出版日期:2018-06-30 发布日期:2018-05-29
  • 通讯作者: 刘中华 E-mail:zhonghualliu@163.com
  • 作者简介:范晓蕾(1980-),女,主治医师,本科.
  • 基金资助:
    上海市长宁区卫计委科研课题(20124Y03001)

Changes in Serum Tumor Necrosis Factor-α, Interleukin-1β, Interleukin-6, and Interleukin-17 Levels and Their Predictive Value in Clinical Responses to Adalimumab Treatment in Patients with Rheumatoid Arthritis

FAN Xiaolei1, LIU Zhonghua2, YUE Tao1, HE Dongyi1   

  1. 1. Department of Arthrology, Guanghua Integrative Medicine Hospital, Shanghai 200052, China;
    2. Department of Nephrology, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
  • Received:2017-06-09 Online:2018-06-30 Published:2018-05-29

摘要: 目的 评估活动性类风湿关节炎(RA)在阿达木单抗(ADA)治疗前后患者血清促炎细胞因子表达水平的变化及其疗效预测作用。方法 本研究共连续纳入79例活动性RA患者。所有患者均接受ADA 40 mg/2周治疗,持续治疗12周。于基线期和治疗12周后采集血清标本,并采用ELISA检测肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6和IL-17的表达水平。结果 ADA治疗12周后,患者C反应蛋白(CRP)、血沉(ESR)、28关节疾病活动评分(DAS28)相对于基线期均显著下降(均P<0.001),同时血清TNF-α(P<0.001)、IL-1β(P=0.007)、IL-6(P<0.001)和IL-17(P<0.001)水平也显著降低。基线期应答组患者IL-1β(P=0.088)和IL-6(P=0.092)水平数值上高于未应答组,单因素逻辑回归分析发现,基线期IL-1β高表达(P=0.091)和IL-6高表达(P=0.062)可在一定程度上预测临床应答,而多因素逻辑回归分析后发现它们均无独立预测作用。结论 ADA治疗可以显著改善RA患者疾病活动度,下调血清TNF-α、IL-1β、IL-6和IL-17表达水平,此外,治疗前血清IL-1β和IL-6水平可能在一定程度上预测ADA治疗RA患者的临床应答。

关键词: 阿达木单抗, 类风湿关节炎, 临床应答, 炎性细胞因子

Abstract: Objective To investigate the changes in serum levels of pro-inflammatory cytokines and their predictive value in clinical responses to adalimumab(ADA) treatment in patients with rheumatoid arthritis(RA). Methods This study consecutively enrolled 79 active RA patients who received 40 mg ADA every 2-weeks for 12 weeks. Serum samples were obtained at the baseline and at 12 weeks post treatment. Serum tumor necrosis factor(TNF) α, interleukin(IL) -1β, IL-6, and IL-17 levels were detected by ELISA. Results CRP, ESR, and the DAS28 score decreased after 12-week ADA treatments(all P<0.001). Serum TNF-α(P<0.001), IL-1β(P=0.007), IL-6 (P<0.001), and IL-17(P<0.001) levels also decreased. The baseline IL-1β(P=0.088) and IL-6(P=0.092) levels were found to be elevated in the response group compared to that in the non-response group. Univariate logistic regression analysis revealed that high baseline expression of IL-1β(P=0.091) and IL-6(P=0.062) might predict a clinical response to ADA treatment;however, multivariate logistic regression analysis revealed that neither IL-1β nor IL-6 could predict clinical response independently. Conclusion Serum TNF-α, IL-1β, IL-6, and IL-17 levels were downregulated in patients with RA after ADA therapy, and high baseline expression of IL-1β and IL-6 might predict clinical response to ADA treatment.

Key words: adalimumab, rheumatoid arthritis, clinical response, inflammatory cytokines

中图分类号: 

  • R593.22
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