Knudsen Lene S, Klarlund Mette, Skjødt Henrik, Jensen Trine, Ostergaard Mikkel, Jensen Karl Erik, Hansen Michael S, Hetland Merete L, Nielsen Hans J, Johansen Julia S
Department of Rheumatology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
J Rheumatol. 2008 Jul;35(7):1277-87. Epub 2008 Jun 15.
To determine plasma interleukin 6 (pIL-6), plasma vascular endothelial growth factor (pVEGF), and serum (s) YKL-40 in patients with early rheumatoid arthritis (RA) and unclassified polyarthritis (PA), and investigate their relationship with radiographic outcome.
pIL-6 and pVEGF were determined by ELISA and sYKL-40 by an in-house radioimmunoassay in 51 patients with early RA and 21 with PA. Patients were followed with clinical and biochemical measurement every month for 2 years. Conventional radiographs of hands, wrists, and forefeet were scored according to the Larsen method, and magnetic resonance imaging of 2nd to 5th metacarpophalangeal joints of the dominant hand were evaluated for presence or absence of bone erosions.
Baseline pIL-6, pVEGF, sYKL-40, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were elevated in RA patients compared to healthy persons (p < 0.001), but were not in patients with PA. Patients with early RA had higher pIL-6 (p = 0.007), pVEGF (p = 0.02), and sYKL-40 (p = 0.024) compared to PA patients. pIL-6, sYKL-40, CRP, and ESR but not pVEGF decreased in patients that responded to treatment after 2 years. The mean value of pIL-6 during the first and second year were higher in patients with early RA with progression in bone erosions (n = 14) compared to early RA patients without progression (n = 30; first year 8.4 vs 2.8 ng/l, p = 0.04; second year 6.1 vs 3.6 ng/l, p = 0.03).
Plasma IL-6 was the only biomarker related to treatment response and progressive erosive disease in patients with early RA, but it may not give additional information compared to CRP in relation to disease activity and treatment response.
测定早期类风湿关节炎（RA）和未分类多关节炎（PA）患者的血浆白细胞介素6（pIL-6）、血浆血管内皮生长因子（pVEGF）和血清YKL-40，并研究它们与放射学结果的关系。
采用酶联免疫吸附测定法（ELISA）测定51例早期RA患者和21例PA患者的pIL-6和pVEGF，采用内部放射免疫测定法测定sYKL-40。患者每月进行临床和生化检测，持续2年。根据Larsen方法对手、腕和前足的传统X线片进行评分，并对优势手的第2至第5掌指关节进行磁共振成像，评估是否存在骨侵蚀。
与健康人相比，RA患者的基线pIL-6、pVEGF、sYKL-40、C反应蛋白（CRP）和红细胞沉降率（ESR）升高（p<0.001），而PA患者则未升高。与PA患者相比，早期RA患者的pIL-6（p=0.007）、pVEGF（p=0.02）和sYKL-40（p=0.024）更高。2年后对治疗有反应的患者，其pIL-6、sYKL-40、CRP和ESR下降，但pVEGF未下降。与无骨侵蚀进展的早期RA患者（n=30）相比，有骨侵蚀进展的早期RA患者（n=14）在第一年和第二年的pIL-6平均值更高（第一年：8.4 vs 2.8 ng/l，p=0.04；第二年：6.1 vs 3.6 ng/l，p=0.03）。
血浆IL-6是早期RA患者中唯一与治疗反应和进行性侵蚀性疾病相关的生物标志物，但与CRP相比，在疾病活动和治疗反应方面可能并未提供更多信息。
