Kanbe Katsuaki, Inoue Kazuhiko, Inoue Yasuo, Suzuki Yutaka
Department of Orthopaedic Surgery, Tokyo Women's Medical University, Medical Center East, Arakawa, Tokyo, Japan.
Clin Rheumatol. 2008 Apr;27(4):497-501. doi: 10.1007/s10067-007-0790-z. Epub 2007 Nov 27.
To investigate histological evidence of bone remodeling in response to infliximab for rheumatoid arthritis (RA), bone marrow tissues were extracted from ten RA patients at the time of total knee arthroplasty after treatment of infliximab for an average of 16 months (range, 8-24 months). The patients had a mean age of 65.3 years (range, 57-76 years) with 4.8 mg/week of methotrexate (MTX; 4-6 mg) and 3.8 mg/day of prednisolone (2-5 mg). Control samples were obtained from ten RA patients who did not undergo infliximab therapy. These patients had an average age of 67.6 years (range, 59-78 years) and received 5.2 mg/week of MTX (4-6 mg) and 4.0 mg/day of prednisolone (2-5 mg). Histological examination of structural differences between the infliximab and control groups in bone marrow was performed using hematoxylin and eosin (H & E) to evaluate differences. In immunohistochemical examination, the expressions of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), receptor activator of nuclear (kappa) B ligand (RANKL), osteoprotegerin (OPG), and osteopontin (OPN) were compared between both groups. H & E staining revealed that the bone marrow tissues of the RA patients who underwent infliximab therapy demonstrated newly formed thickness of interstitial septum among the trabeculae as compared with the control group. Moreover, immunohistochemical examinations revealed that TNF-alpha, IL-6, RANKL, OPG, and OPN were expressed in this newly formed bone after infliximab therapy. Therefore, treatment with infliximab improved the histological changes with respect to bone metabolism in the newly formed bone marrow tissues.
为了研究英夫利昔单抗治疗类风湿性关节炎（RA）后骨重塑的组织学证据，在接受英夫利昔单抗治疗平均16个月（范围8 - 24个月）后行全膝关节置换术时，从10例RA患者中提取骨髓组织。患者的平均年龄为65.3岁（范围57 - 76岁），服用甲氨蝶呤（MTX；4 - 6mg）4.8mg/周，泼尼松龙3.8mg/天（2 - 5mg）。对照样本取自10例未接受英夫利昔单抗治疗的RA患者。这些患者的平均年龄为67.6岁（范围59 - 78岁），服用MTX 5.2mg/周（4 - 6mg），泼尼松龙4.0mg/天（2 - 5mg）。使用苏木精和伊红（H&E）对英夫利昔单抗组和对照组骨髓的结构差异进行组织学检查以评估差异。在免疫组织化学检查中，比较了两组肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、核因子κB受体活化因子配体（RANKL）、骨保护素（OPG）和骨桥蛋白（OPN）的表达。H&E染色显示，与对照组相比，接受英夫利昔单抗治疗的RA患者的骨髓组织在小梁间显示出新形成的间质隔厚度。此外，免疫组织化学检查显示，英夫利昔单抗治疗后，TNF-α、IL-6、RANKL、OPG和OPN在这种新形成的骨中表达。因此，英夫利昔单抗治疗改善了新形成的骨髓组织中骨代谢的组织学变化。
