Program in Molecular Oncology, Experimental Immunology and Development of Innovative Therapies, University of Catanzaro Magna Graecia campus Salvatore Venuta, viale Europa, 88100 Catanzaro, Italy.
Clin Rheumatol. 2012 Sep;31(9):1401-2. doi: 10.1007/s10067-012-2034-0. Epub 2012 Jul 27.
Insulin resistance, a key feature of type 2 diabetes, is an independent risk factor for developing cardiovascular diseases (CVD), and represents the core of metabolic syndrome (MetS). Actually, an intriguing correlation between MetS and inflammation associated with rheumatoid arthritis (RA) is largely accepted but not yet completely clarified in detail. Recently, the therapeutic arsenal against RA has been enriched of abatacept, a fusion protein (CTLA4 immunoglobulin) designed to modulate the T cell co-stimulatory signal mediated through the CD28-CD80/86 pathway. Here, we report a case of dramatic improvement in insulin resistance, estimated with the surrogate measure HOMA-IR, after treatment with abatacept. Lastly, we shortly review the preclinical evidences supporting a possible role of T lymphocytes in rheumatoid arthritis-associated insulin resistance and how abatacept could improve glucose metabolism by suppressing adipose tissue infiltrating cells.
胰岛素抵抗是 2 型糖尿病的一个主要特征，也是心血管疾病 (CVD) 的独立危险因素，代表代谢综合征 (MetS) 的核心。实际上，代谢综合征与类风湿关节炎 (RA) 相关炎症之间存在有趣的相关性，这在很大程度上已被接受，但尚未完全详细阐明。最近，类风湿关节炎的治疗手段已经丰富了阿巴西普，一种融合蛋白 (CTLA4 免疫球蛋白)，旨在通过 CD28-CD80/86 途径调节 T 细胞共刺激信号。在这里，我们报告了一例使用替代指标 HOMA-IR 评估的胰岛素抵抗显著改善的病例，该病例在使用阿巴西普治疗后得到改善。最后，我们简要回顾了支持 T 淋巴细胞在类风湿关节炎相关胰岛素抵抗中可能作用的临床前证据，以及阿巴西普如何通过抑制脂肪组织浸润细胞来改善葡萄糖代谢。
