Gonzalez-Gay M A, Garcia-Unzueta M T, De Matias J M, Gonzalez-Juanatey C, Garcia-Porrua C, Sanchez-Andrade A, Martin J, Llorca J
Division of Rheumatology, Hospital Xeral Calde, Lugo, Spain.
Clin Exp Rheumatol. 2006 Jul-Aug;24(4):373-9.
Chronic systemic inflammation plays a pivotal role in the development of atherosclerosis in rheumatoid arthritis (RA). Soluble (s) adhesion molecules were found significantly increased in RA patients with active disease. Since increased levels of some adhesion molecules were closely linked to the development of endothelial dysfunction and atherosclerosis and administration of anti-TNF-alpha-infliximab resulted in a rapid and dramatic improvement of endothelial function in long-term infliximab treated RA patients, we assessed whether infusion of the chimeric anti-TNF-alpha infliximab might also yield a rapid and favorable effect on serum levels of soluble adhesion molecules in RA patients periodically treated with this drug because of severe disease.
We recruited patients with RA refractory to conventional therapy seen over a period of 2 months at Hospital Xeral-Calde, Lugo, Spain, who were on periodical treatment with infliximab for at least 14 weeks. Blood samples for determination of sICAM-1, sICAM-3, sVCAM-1, sE-selectin, and sP-selectin levels by ELISA were taken immediately before and after infliximab infusion.
Thirty-four RA patients (25 women; mean age: 55.4 years; mean DAS28: 4.27) fulfilled the inclusion criteria. Following infliximab infusion a reduction of the overall mean values of the five adhesion molecules was observed. However, when a Wilcoxon signed-rank test was used, only significant differences for sICAM-3 and sP-selectin were observed. In this regard, sICAM-3 and sP-selectin levels fell in 26 (77%) and 28 (82%) of the 34 patients.
Our study confirms a rapid and beneficial effect of infliximab infusion on expression of some adhesion molecules in RA patients treated periodically with this anti-TNF-alpha monoclonal antibody because of severe disease.
慢性全身性炎症在类风湿关节炎（RA）动脉粥样硬化的发展中起关键作用。在患有活动性疾病的RA患者中，可溶性（s）黏附分子显著增加。由于某些黏附分子水平的升高与内皮功能障碍和动脉粥样硬化的发展密切相关，并且给予抗TNF-α英夫利昔单抗可使长期接受英夫利昔单抗治疗的RA患者的内皮功能迅速且显著改善，因此我们评估了对于因病情严重而定期接受该药物治疗的RA患者，输注嵌合抗TNF-α英夫利昔单抗是否也可能对可溶性黏附分子的血清水平产生快速且有益的影响。
我们招募了在西班牙卢戈市塞拉尔 - 卡尔德医院在2个月期间就诊的对传统治疗无效的RA患者，这些患者接受英夫利昔单抗定期治疗至少14周。在英夫利昔单抗输注前后立即采集血样，通过酶联免疫吸附测定法（ELISA）测定sICAM - 1、sICAM - 3、sVCAM - 1、sE - 选择素和sP - 选择素水平。
34例RA患者（25名女性；平均年龄：55.4岁；平均DAS28：4.27）符合纳入标准。英夫利昔单抗输注后，观察到五种黏附分子的总体平均值降低。然而，当使用Wilcoxon符号秩检验时，仅观察到sICAM - 3和sP - 选择素存在显著差异。在这方面，34例患者中有26例（77%）的sICAM - 3水平下降，28例（82%）的sP - 选择素水平下降。
我们的研究证实，对于因病情严重而定期接受这种抗TNF - α单克隆抗体治疗RA患者，英夫利昔单抗输注对某些黏附分子的表达具有快速且有益的影响。
