Schneider E M, Ma X, Stratz T, Müller W, Lorenz I, Seeling W D
Section of Experimental Anesthesiology, University Clinic Ulm, Ulm, Germany.
Scand J Rheumatol Suppl. 2004;119:34-40.
To characterize the immune modulatory effects of 5-HT3 receptor antagonist treatment in patients with fibromyalgia, autoimmune disorders, and chronic pain.
Multiplex-assisted cytokine measurements were performed before and during treatment. Whole blood stimulation with TNF-alpha was carried out to determine the proinflammatory response induced by exogenous TNF-alpha.
Five of nine patients clinically responded to treatment, and two had a moderate response. All patients had significantly elevated levels of T-H1 cytokines more prominent than TNF-alpha, IL-1beta, and IL-6. Treatment resulted in transient effects on peripheral monocyte counts in all but one patient, a plasma IL-1beta increase in two responder patients, and decreased T-H1 cytokines in two responder patients. Ex vivo TNF-alpha stimulation was transiently reconstituted in three responder patients to a significant level. Three patients showed a marginal reconstitutive response.
5-HT3 receptor blockade transiently affects monocyte tissue infiltration, modulates T-H1 cytokines in clinical responders as well as MIP-1beta in moderate responders, and transiently affects the ex vivo response to exogenous TNF-alpha.
描述5-羟色胺3（5-HT3）受体拮抗剂治疗纤维肌痛、自身免疫性疾病和慢性疼痛患者的免疫调节作用。
在治疗前及治疗期间进行多重细胞因子检测。用肿瘤坏死因子-α（TNF-α）对全血进行刺激，以确定外源性TNF-α诱导的促炎反应。
9例患者中有5例临床治疗有效，2例有中度反应。所有患者的辅助性T1（T-H1）细胞因子水平均显著升高，比TNF-α、白细胞介素-1β（IL-1β）和白细胞介素-6更为明显。治疗对除1例患者外的所有患者的外周单核细胞计数产生短暂影响，2例有反应的患者血浆IL-1β升高，2例有反应的患者T-H1细胞因子降低。3例有反应的患者体外TNF-α刺激短暂恢复到显著水平。3例患者表现出轻微的恢复反应。
5-HT3受体阻断可短暂影响单核细胞组织浸润，调节有临床反应患者的T-H1细胞因子以及中度反应患者的巨噬细胞炎性蛋白-1β（MIP-1β），并短暂影响对外源性TNF-α的体外反应。
