Marra M, Campanati A, Testa R, Sirolla C, Bonfigli A R, Franceschi C, Marchegiani F, Offidani A
Diabetology Unit, INRCA, Ancona, Italy.
Int J Immunopathol Pharmacol. 2007 Oct-Dec;20(4):731-6. doi: 10.1177/039463200702000408.
Metabolic syndrome is associated to chronic low grade inflammation, characterized by increased levels of inflammatory cytokines, such as Tumor Necrosis Factor-alpha (TNF-alpha) and Interleukin-6 (IL-6). In particular, TNF-alpha causes a decrease in the insulin-stimulated kinases related to the early phases of the insulin cascade, thereby leading to insulin resistance. Etanercept is a human fusion protein used in the treatment of psoriasis and inflammatory arthritis. It blocks inflammatory response by interfering in the binding of TNF-alpha to its receptors. The aim of this case report study is to verify the effect of Etanercept on insulin sensitivity, lipid profile and inflammatory status in psoriatic patients. Nine psoriatic patients with stable, active, plaque type psoriasis were enrolled and treated with Etanercept for 24 weeks. We found an improvement in the metabolic assessment with a significant reduction of insulin plasma levels. In particular, this treatment allows to maintain their euglycemic state with lower insulin plasma levels, as confirmed by the improved Homeostasis Model Assessment (HOMA) index. We conclude that Etanercept, probably acting on inflammation, improves insulin sensitivity in psoriatic subjects.
代谢综合征与慢性低度炎症相关，其特征为炎性细胞因子水平升高，如肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）。特别是，TNF-α会导致与胰岛素级联反应早期阶段相关的胰岛素刺激激酶减少，从而导致胰岛素抵抗。依那西普是一种用于治疗银屑病和炎性关节炎的人融合蛋白。它通过干扰TNF-α与其受体的结合来阻断炎症反应。本病例报告研究的目的是验证依那西普对银屑病患者胰岛素敏感性、血脂谱和炎症状态的影响。招募了9名患有稳定、活动性斑块型银屑病的患者，并用依那西普治疗24周。我们发现代谢评估有所改善，胰岛素血浆水平显著降低。特别是，这种治疗能够以较低的胰岛素血浆水平维持其血糖正常状态，稳态模型评估（HOMA）指数的改善证实了这一点。我们得出结论，依那西普可能通过作用于炎症来改善银屑病患者的胰岛素敏感性。
