Levälampi T, Honkanen V, Lahdenne P, Nieminen R, Hakala M, Moilanen E
The Immunopharmacology Research Group, Medical School, University of Tampere and Research Unit, Tampere University Hospital, Tampere, Finland.
Scand J Rheumatol. 2007 May-Jun;36(3):189-93. doi: 10.1080/03009740601089234.
Infliximab is effective and well tolerated in the treatment of juvenile idiopathic arthritis (JIA). The aim of the present study was to measure circulating levels of inflammatory mediators in patients with JIA during treatment with infliximab.
Eight patients with active JIA refractory to standard treatments were treated with infliximab (3-4 mg/kg) at weeks 0, 2 and 6 and thereafter at approximately 6-week intervals up to 24 weeks.
All patients (n = 8) responded to the treatment. By 6 weeks of treatment the number of active joints had reduced from 16+/-4 (mean+/-SEM) to 4+/-1 (p<0.01) and C-reactive protein (CRP) levels had fallen from 31+/-8 to 8+/-3 (p<0.001). Infliximab treatment also reduced the serum concentrations of interleukin-6 (IL-6), myeloperoxidase (MPO), and soluble adhesion molecules ICAM-1 (intercellular adhesion molecule-1), and E-selectin. Tumour necrosis factor-alpha (TNFalpha) levels tended to increase while the concentrations of endogenous TNF antagonists (sTNF-RI and sTNF-RII) reduced in most patients during treatment.
Infliximab reduced serum levels of IL-6, MPO and soluble adhesion molecules in JIA patients, producing a good clinical response to the treatment.
英夫利昔单抗在治疗幼年特发性关节炎（JIA）方面有效且耐受性良好。本研究的目的是测量JIA患者在接受英夫利昔单抗治疗期间炎症介质的循环水平。
8例对标准治疗无效的活动性JIA患者在第0、2和6周接受英夫利昔单抗（3 - 4mg/kg）治疗，此后每隔约6周治疗一次，直至24周。
所有患者（n = 8）对治疗均有反应。治疗6周时，活动关节数量从16±4（均值±标准误）减少至4±1（p<0.01），C反应蛋白（CRP）水平从31±8降至8±3（p<0.001）。英夫利昔单抗治疗还降低了白细胞介素-6（IL-6）、髓过氧化物酶（MPO）以及可溶性黏附分子细胞间黏附分子-1（ICAM-1）和E-选择素的血清浓度。肿瘤坏死因子-α（TNFα）水平趋于升高，而在大多数患者治疗期间内源性TNF拮抗剂（sTNF-RI和sTNF-RII）的浓度降低。
英夫利昔单抗降低了JIA患者血清中IL-6、MPO和可溶性黏附分子的水平，对治疗产生了良好的临床反应。
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