First Department of Propaedeutic and Internal Medicine, Medical School, University of Athens, Athens, Greece.
Rheumatology (Oxford). 2013 Mar;52(3):448-51. doi: 10.1093/rheumatology/kes316. Epub 2012 Nov 30.
To determine the expression of soluble TNF-like cytokine 1A (sTL1A), a new member of the TNF superfamily, in patients with AS.
Seventy-five consecutive patients with AS [61 males, mean (S.D.) age: 47.2 (15.5) years, disease duration: 20.3 (13.9) years] were included in this study. Forty-four patients were anti-TNF treatment naïve, whereas the remaining patients were on infliximab (n = 21), adalimumab (n = 3) or etanercept (n = 7). The patients' perceived disease activity was recorded by BASDAI and AS DAS using serum CRP levels (ASDAS-CRP), whereas functional status was assessed by BASFI and measurements of spinal mobility (AS Metrology). Serum concentrations of TL1A were measured by ELISA. Twenty-five age- and sex-matched healthy individuals served as controls.
Anti-TNF treatment-naïve patients demonstrated a 2.6-fold higher sTL1A average value [mean (s.e.m.) 581 (157.5) pg/ml] compared with healthy controls [226.7 (48.24) pg/ml, P = 0.042]. The sTL1A levels of anti-TNF-treated patients [178 (42)] were significantly lower than anti-TNF treatment-naïve patients (3.3-fold decrease, P = 0.0038) and comparable to those of healthy controls. No significant association was found between sTL1A level and functional status (BASFI score, AS Metrology parameters) or CRP measured in the same sera; however, a positive correlation was observed between individual levels of sTL1A and both BASDAI (P = 0.008) and ASDAS-CRP (P = 0.058) scores suggesting that sTL1A levels may reflect disease activity in patients with AS.
TL1A is up-regulated in AS, associates with disease activity and is influenced by anti-TNF treatment, suggesting that TL1A may be of pathogenic and potentially of therapeutic importance in AS patients.
检测肿瘤坏死因子超家族新成员可溶性肿瘤坏死因子样配体 1A（sTL1A）在 AS 患者中的表达。
本研究共纳入 75 例连续的 AS 患者（61 例男性，平均年龄为 47.2±15.5 岁，病程为 20.3±13.9 年）。其中 44 例患者未接受过抗 TNF 治疗，其余患者接受过英夫利昔单抗（n=21）、阿达木单抗（n=3）或依那西普（n=7）治疗。BASDAI 和基于 CRP 的 AS 疾病活动度评分（ASDAS-CRP）记录患者的主观疾病活动度，BASFI 和脊柱活动度测量（AS 计量学）评估患者的功能状态。通过 ELISA 法检测血清 TL1A 浓度。25 名年龄和性别匹配的健康个体作为对照。
与健康对照组相比，未接受过抗 TNF 治疗的患者 sTL1A 的平均水平（581.7±157.5 pg/ml）高出 2.6 倍[226.7±48.24 pg/ml，P=0.042]。抗 TNF 治疗患者的 sTL1A 水平[178（42）]显著低于未接受过抗 TNF 治疗的患者（3.3 倍降低，P=0.0038），与健康对照组相当。sTL1A 水平与功能状态（BASFI 评分、AS 计量学参数）或同一血清中的 CRP 无显著相关性；然而，个体 sTL1A 水平与 BASDAI（P=0.008）和 ASDAS-CRP（P=0.058）评分呈正相关，提示 sTL1A 水平可能反映 AS 患者的疾病活动度。
TL1A 在 AS 中上调，与疾病活动度相关，并受抗 TNF 治疗影响，表明 TL1A 可能在 AS 患者中具有致病作用和潜在的治疗意义。
