依那西普治疗类风湿关节炎患者出现克雅病：纯属巧合？

Creutzfeldt-Jakob disease in a patient treated by etanercept for rheumatoid arthritis (RA): just a coincidence?

机构信息

Service de rhumatologie, hôpital G. Montpied, place Henri-Dunant, BP 69, 63003 Clermont-Ferrand, France.

出版信息

Joint Bone Spine. 2010 Mar;77(2):174-5. doi: 10.1016/j.jbspin.2009.05.016. Epub 2010 Jan 25.

DOI:10.1016/j.jbspin.2009.05.016

PMID:20097590

Abstract

We describe a patient in whom sporadic Creutzfeldt-Jakob disease (sCJD) occurred one year after the onset of etanercept therapy for rheumatoid arthritis (RA). This association could be a chance occurrence. However, TNF-alpha has been implicated in the pathogenesis of neurodegeneration in sCJD and etanercept might worsen the disease. Such an aggravation has been observed in multiple sclerosis, in which TNF-alpha is the key mediator of demyelination. It may be of interest studying the impact of treatment with TNF-alpha antagonists on prevalence and incidence of those neurodegenerative diseases involving TNF-alpha mediation, such as Alzheimer disease.

摘要

我们描述了一例患者，其在接受依那西普（etanercept）治疗类风湿关节炎（RA）一年后出现散发性克雅氏病（sCJD）。这种关联可能是偶然发生的。然而，TNF-α 已被牵连到 sCJD 神经退行性变的发病机制中，依那西普可能会使疾病恶化。这种恶化在多发性硬化症中已经观察到，其中 TNF-α 是脱髓鞘的关键介质。研究 TNF-α 拮抗剂治疗对涉及 TNF-α 介导的神经退行性疾病（如阿尔茨海默病）的患病率和发病率的影响可能会很有趣。