Broegelmann Research Laboratory, Gade Institute, University of Bergen, Bergen, Norway.
Int Immunopharmacol. 2011 Dec;11(12):2125-9. doi: 10.1016/j.intimp.2011.09.006. Epub 2011 Sep 29.
Immunomodulating drugs are commonly used in treating patients with autoimmune diseases but with very different outcomes. We aimed to investigate differences in cytokine and autoantibody levels with regard to patient characteristics in patients with primary Sjögren's syndrome (pSS) receiving oral steroids or antimalarial drugs (AM) after a longer period of time.
Serum samples from 141 patients fulfilling the revised EU-US criteria and 99 healthy controls were analysed for 25 cytokines and 8 autoantibodies.
AM-patients had lowered levels of IL-5, IL-10, IL-13 and IFN-γ, though non-significantly. Use of prednisolone was associated with reduced levels of IL-15, IL-2, IL-4, IL-12p40, TNF-α, MIP-1α and MIP-1β (p<0.05), and a trend towards decreased levels of IL-1RA and IL-1β was observed. No associations were seen between AM and antibody levels. Significantly higher protein levels of anti-Ro-52 and anti-Ro-60 were observed in the patients taking prednisolone (p<0.05). The proportion of patients positive for anti-Ro-52 and anti-La-48 did not differ significantly in the groups taking and not taking prednisolone, but a difference was seen for anti-Ro-60 (p<0.05).
Prednisolone is a potent anti-inflammatory and immunosuppressive drug commonly used in autoimmune diseases. Our study shows that oral steroids are associated with reduced levels of several pro-inflammatory cytokines, but increased levels of pSS specific autoantibodies. The association between steroid use and increased antibody levels is not readily explained by known steroid effects, and should therefore be confirmed in further studies. Lower levels of pro-inflammatory cytokines indicate a beneficial effect of oral steroids in this patient group.
免疫调节药物常用于治疗自身免疫性疾病患者，但疗效差异很大。我们旨在研究原发性干燥综合征（pSS）患者在接受较长时间的口服类固醇或抗疟药物（AM）治疗后，根据患者特征，细胞因子和自身抗体水平的差异。
分析了 141 名符合修订后的 EU-US 标准的患者和 99 名健康对照者的血清样本，检测了 25 种细胞因子和 8 种自身抗体。
AM 患者的 IL-5、IL-10、IL-13 和 IFN-γ 水平降低，但无统计学意义。使用泼尼松龙与 IL-15、IL-2、IL-4、IL-12p40、TNF-α、MIP-1α 和 MIP-1β 水平降低相关（p<0.05），且 IL-1RA 和 IL-1β 水平呈下降趋势。AM 与抗体水平之间无相关性。服用泼尼松龙的患者抗 Ro-52 和抗 Ro-60 的蛋白水平显著升高（p<0.05）。服用和未服用泼尼松龙的患者抗 Ro-52 和抗 La-48 的阳性率无显著差异，但抗 Ro-60 的阳性率有差异（p<0.05）。
泼尼松龙是一种常用于治疗自身免疫性疾病的有效抗炎和免疫抑制剂。我们的研究表明，口服类固醇与几种促炎细胞因子水平降低有关，但与 pSS 特异性自身抗体水平升高有关。类固醇使用与抗体水平升高之间的关联不能用已知的类固醇作用轻易解释，因此应在进一步的研究中加以证实。促炎细胞因子水平降低表明口服类固醇对该患者群体具有有益作用。
