Knudsen Lene Surland, Hetland Merete Lund, Johansen Julia Sidenius, Skjødt Henrik, Peters Niels Daugaard, Colic Ada, Grau Karin, Nielsen Hans Jørgen, Ostergaard Mikkel
Department of Rheumatology, Copenhagen University Hospital at Herlev, Denmark.
Biomark Insights. 2009 Sep 23;4:91-5. doi: 10.4137/bmi.s2300.
Changes in plasma IL-6, plasma VEGF and serum YKL-40 were determined in rheumatoid arthritis (RA) patients during treatment with etanercept alone or in combination with methotrexate. Twenty-five patients with active RA (DAS28 >/= 3.2) were randomized to receive etanercept (25 mg sc. biweekly) plus methotrexate (n = 12) or etanercept alone (n = 13). Plasma IL-6, plasma VEGF and serum YKL-40 were determined by ELISA. The 3 biomarkers and DAS28 scores were evaluated at baseline and after 4, 8, 12 and 16 weeks of treatment. At inclusion all patients had significantly (p < 0.001) elevated plasma IL-6, plasma VEGF and serum YKL-40 compared to healthy subjects. Eighteen patients responded to treatment (pooled data from both treatment groups), and they had significant (p < 0.05 to p < 0.001) decreases in plasma IL-6, plasma VEGF, serum YKL-40, ESR and DAS28 after 4 weeks of treatment and throughout the study (except serum YKL-40 at week 16). Plasma IL-6 showed the largest reductions. Non-responders had unchanged biomarkers. At week 16 the patients with DAS28 < 3.2 had lower levels compared to baseline values in plasma IL-6 (p = 0.005), plasma VEGF (p = 0.014), and ESR (p = 0.024).Plasma IL-6, plasma VEGF and serum YKL-40, which reflect different aspects of the inflammatory process, may provide useful information regarding early differentiation of responders from non-responders.
在类风湿关节炎（RA）患者单独使用依那西普或联合甲氨蝶呤治疗期间，测定了血浆白细胞介素-6（IL-6）、血浆血管内皮生长因子（VEGF）和血清YKL-40的变化。25例活动期RA患者（疾病活动度评分DAS28≥3.2）被随机分为两组，一组接受依那西普（25mg皮下注射，每两周一次）加甲氨蝶呤（n = 12），另一组仅接受依那西普（n = 13）。采用酶联免疫吸附测定法（ELISA）测定血浆IL-6、血浆VEGF和血清YKL-40。在基线以及治疗4、8、12和16周后评估这三种生物标志物和DAS28评分。纳入研究时，与健康受试者相比，所有患者的血浆IL-6、血浆VEGF和血清YKL-40均显著升高（p < 0.001）。18例患者对治疗有反应（两个治疗组的汇总数据），治疗4周后及整个研究期间（第16周时血清YKL-40除外），他们的血浆IL-6、血浆VEGF、血清YKL-40、红细胞沉降率（ESR）和DAS28均显著降低（p < 0.05至p < 0.001）。血浆IL-6的降低幅度最大。无反应者的生物标志物无变化。在第16周时，DAS28 < 3.2的患者血浆IL-6（p = 0.005）、血浆VEGF（p = 0.014）和ESR（p = 0.024）水平低于基线值。反映炎症过程不同方面的血浆IL-6、血浆VEGF和血清YKL-40，可能为区分反应者和无反应者提供有用信息。
