Dasgupta B, Panayi G S
Rheumatology Unit, UMDS, Guy's Hospital, London.
Br J Rheumatol. 1990 Dec;29(6):456-8. doi: 10.1093/rheumatology/29.6.456.
Polymyalgia rheumatica and giant cell arteritis are diseases which are characterized by a brisk acute phase response. Cytokines, principally interleukin-1 and interleukin-6, are thought to mediate the release of acute phase proteins from hepatocytes. Employing a sensitive bioassay based on the hybridoma growth factor properties of interleukin-6, we investigated its levels in sequential sera obtained from 15 initially untreated patients with PMR/GCA. We found that interleukin-6 activity was significantly elevated in all untreated patients. Although there was a significant decline in its levels after successful steroid therapy, seven patients continued to have raised serum levels of interleukin-6 for up to 6 months after initiation of treatment. Activated endothelial cells are a potent source of interleukin-6 and its persistence in the circulation may be taken as evidence of continuing disease activity. What is not explicable is the normalization of the acute phase response soon after the commencement of steroid therapy when circulating levels of interleukin-6 are still high. This suggests that steroids may be having additional effects on hepatocyte function.
风湿性多肌痛和巨细胞动脉炎是以急性期反应活跃为特征的疾病。细胞因子，主要是白细胞介素-1和白细胞介素-6，被认为介导了肝细胞释放急性期蛋白。我们采用基于白细胞介素-6杂交瘤生长因子特性的灵敏生物测定法，研究了15例未经治疗的PMR/GCA患者连续血清中白细胞介素-6的水平。我们发现，所有未经治疗的患者白细胞介素-6活性均显著升高。虽然成功使用类固醇治疗后其水平显著下降，但7例患者在开始治疗后长达6个月血清白细胞介素-6水平仍升高。活化的内皮细胞是白细胞介素-6的重要来源，其在循环中的持续存在可能被视为疾病持续活动的证据。无法解释的是，在类固醇治疗开始后不久急性期反应就恢复正常，而此时循环中的白细胞介素-6水平仍然很高。这表明类固醇可能对肝细胞功能有额外的作用。
