Comby Elisabeth, Tanaff Pascale, Mariotte Delphine, Costentin-Pignol Valerie, Marcelli Christian, Ballet Jean Jacques
Laboratoire d'Immunologie et Immunopathologie, UPRES-EA 2128, and Service de Rhumatologie, CHU, Caen, France.
J Rheumatol. 2006 Jan;33(1):24-30.
To investigate the effect of longterm infliximab therapy on serum levels of fluorescent antinuclear and anti-double and single-stranded DNA antibodies (FANA, anti-dsDNA, anti-ssDNA) in patients with rheumatoid arthritis (RA), and their possible association with clinical evolution.
Sera from 58 RA patients, treated for one to 3 years with infliximab, were retrospectively analyzed. Matched control groups were RA patients treated with corticosteroids or methotrexate. FANA were tested using HEp-2 cells, and anti-dsDNA and anti-ssDNA IgG by ELISA. After 28 months of infliximab therapy, clinical status was evaluated in 43/58 patients with uninterrupted therapy and associations with autoantibody levels were investigated. Data were documented for patients who discontinued infliximab.
Over the 3 year period, significant increases in FANA and anti-ssDNA IgG levels were observed in infliximab treated patients (p < 0.001 and p < 0.01, respectively). In 43 patients with an uninterrupted infliximab regimen, association was found between high FANA (>or= 1/1280) and lower age (p = 0.048) and patient's assessment of infliximab's efficacy (p = 0.014). Three patients developed anti-dsDNA IgG, preceded by high anti-ssDNA IgG levels, and one of them developed a lupus-like syndrome. Neither the initial presence of high FANA levels nor their increase >or= 1/1280 was significantly associated with discontinuation of infliximab. In contrast, at baseline (p = 0.0012) and at the time of infliximab discontinuation (p = 0.0078), anti-ssDNA IgG (>or= 500 arbitrary units) were more frequent in 7 patients who stopped infliximab due to skin or systemic anaphylactoid reactions.
Monitoring of serum FANA, anti-dsDNA, and anti-ssDNA IgG antibodies provided predictors of lupus-like symptoms and/or anaphylactoid reactions in patients with RA.
研究长期使用英夫利昔单抗治疗对类风湿关节炎（RA）患者血清中荧光抗核抗体及抗双链和单链DNA抗体（FANA、抗dsDNA、抗ssDNA）水平的影响，以及它们与临床病情进展的可能关联。
回顾性分析58例接受英夫利昔单抗治疗1至3年的RA患者的血清。匹配的对照组为接受皮质类固醇或甲氨蝶呤治疗的RA患者。使用HEp-2细胞检测FANA，通过ELISA检测抗dsDNA和抗ssDNA IgG。在英夫利昔单抗治疗28个月后，对43例接受不间断治疗的患者进行临床状况评估，并研究其与自身抗体水平的关联。记录停用英夫利昔单抗患者的数据。
在3年期间，接受英夫利昔单抗治疗的患者中FANA和抗ssDNA IgG水平显著升高（分别为p < 0.001和p < 0.01）。在43例接受不间断英夫利昔单抗治疗方案的患者中，发现高FANA（≥1/1280）与较低年龄（p = 0.048）以及患者对英夫利昔单抗疗效的评估（p = 0.014）之间存在关联。3例患者出现抗dsDNA IgG，之前抗ssDNA IgG水平较高，其中1例出现狼疮样综合征。FANA水平初始较高或升高≥1/1280均与停用英夫利昔单抗无显著关联。相比之下，在基线时（p = 0.0012）以及停用英夫利昔单抗时（p = 0.0078），7例因皮肤或全身性类过敏反应而停用英夫利昔单抗的患者中，抗ssDNA IgG（≥500任意单位）更为常见。
监测血清FANA、抗dsDNA和抗ssDNA IgG抗体可为RA患者狼疮样症状和/或类过敏反应提供预测指标。
Zotero 插件