Department of Orthopaedic Surgery, Narita Memorial Hospital, 78 Shirakawa-cho, Toyohashi, 441-8021, Japan.
Rheumatol Int. 2010 Apr;30(6):725-30. doi: 10.1007/s00296-009-1356-y. Epub 2010 Jan 10.
Tumor necrosis factor-alpha (TNF-alpha) has an essential role in the pathogenesis of rheumatoid arthritis (RA) and has been known to induce the production of several inflammatory molecules in vivo. To analyze in vivo the active mechanism of the TNF-alpha blocking agent, etanercept, the serum levels of the cytokine interleukin-15 (IL-15) and the chemokines growth-regulated protein-alpha (Gro-alpha), and interferon-gamma inducible protein-10 (IP-10) in RA patients were measured. Twenty-two patients with RA were administered etanercept once or twice a week for more than 6 months. The clinical and laboratory parameters were measured and serum levels of IL-15, Gro-alpha, and IP-10 were determined using enzyme-linked immunosorbent assay (ELISA) kits at the baseline and at 3 and 6 months after the initial treatment. Additionally, the production of IL-15 and IP-10 by cultured synovial cells stimulated with TNF-alpha from RA patients was determined by ELISA. A significant decrease in serum levels of IL-15 and IP-10 was observed at 3 and 6 months after initial treatment with etanercept, but not in those of Gro-alpha. TNF-alpha induced production of IP-10, but not IL-15 in cultured synovial cells from RA patients. This study demonstrated for the first time the reduction of IP-10 and IL-15 production in RA patients as active mechanisms of etanercept.
肿瘤坏死因子-α(TNF-α)在类风湿关节炎(RA)的发病机制中起着重要作用,并且已知它能在体内诱导几种炎症分子的产生。为了分析 TNF-α阻断剂依那西普的体内作用机制,我们测量了 RA 患者血清中细胞因子白细胞介素-15(IL-15)和趋化因子生长调节蛋白-α(Gro-α)以及干扰素-γ诱导蛋白-10(IP-10)的水平。22 例 RA 患者接受依那西普每周一次或两次治疗,持续超过 6 个月。在基线和初始治疗后 3 个月和 6 个月时,通过酶联免疫吸附测定(ELISA)试剂盒测量临床和实验室参数,并测定血清中 IL-15、Gro-α和 IP-10 的水平。此外,通过 ELISA 测定 TNF-α刺激 RA 患者的滑膜细胞产生 IL-15 和 IP-10。在初始接受依那西普治疗后 3 个月和 6 个月时,血清中 IL-15 和 IP-10 的水平显著下降,但 Gro-α的水平没有下降。TNF-α诱导 RA 患者培养的滑膜细胞产生 IP-10,但不产生 IL-15。本研究首次证明了依那西普在 RA 患者中的作用机制是减少 IP-10 和 IL-15 的产生。