TNFα 阻断治疗对自身免疫性疾病患者循环脂联素水平的影响：两项独立前瞻性研究的结果。
Lack of effect of TNFalpha blockade therapy on circulating adiponectin levels in patients with autoimmune disease: results from two independent prospective studies.
机构信息
Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands.
出版信息
Ann Rheum Dis. 2010 Sep;69(9):1687-90. doi: 10.1136/ard.2009.114207. Epub 2009 Jul 28.
BACKGROUND
Adiponectin is an anti-inflammatory and potentially antiatherogenic molecule. Some recent reports suggest that tumour necrosis factor alpha (TNFalpha) blockade therapy increases circulating adiponectin levels, but data are sparse and inconsistent.
METHODS
Data from a double-blind placebo controlled study of onercept in 126 patients with psoriatic arthritis (PsA) and from pre- and post-adalimumab treatment in 171 patients with rheumatoid arthritis (RA) were used to examine the effect of TNFalpha blockade therapy on adiponectin.
RESULTS
Despite expected associations of adiponectin with gender and baseline high-density lipoprotein cholesterol and triglyceride, adiponectin levels did not change over time with TNFalpha blockade therapy in either group. The mean+/-SD absolute change in adiponectin levels was -0.23+/-4.6 microg/ml in patients with PsA treated with combined onercept 50 mg and onercept 100 mg (vs placebo, p=0.60) and 0.28+/-3.23 microg/ml in patients with RA treated with adalimumab (vs baseline, p=0.66).
CONCLUSION
These results do not support a significant effect of TNFalpha blockade therapy on circulating adiponectin levels in patients with autoimmune disease.
背景
脂联素是一种具有抗炎作用、可能具有抗动脉粥样硬化作用的分子。一些最新的报告表明，肿瘤坏死因子-α（TNFα）阻断治疗可增加循环脂联素水平，但数据稀少且不一致。
方法
使用来自 126 例银屑病关节炎（PsA）患者接受依那西普双盲安慰剂对照研究的数据，以及来自 171 例类风湿关节炎（RA）患者接受阿达木单抗治疗前后的数据，来研究 TNFα 阻断治疗对脂联素的影响。
结果
尽管脂联素与性别以及高密度脂蛋白胆固醇和甘油三酯的基线水平呈预期关联，但在两组患者中，脂联素水平均未随 TNFα 阻断治疗而随时间发生变化。接受联合依那西普 50mg 和依那西普 100mg 治疗的 PsA 患者（与安慰剂相比，p=0.60）和接受阿达木单抗治疗的 RA 患者（与基线相比，p=0.66）的脂联素水平的平均绝对变化分别为-0.23±4.6μg/ml 和 0.28±3.23μg/ml。
结论
这些结果不支持 TNFα 阻断治疗对自身免疫性疾病患者循环脂联素水平有显著影响。
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