Isaacs John D, Harari Olivier, Kobold Uwe, Lee Janet S, Bernasconi Corrado
Arthritis Res Ther. 2013;15(6):R204. doi: 10.1186/ar4397.
Our objective was to determine the interrelationships of interleukin (IL)-6 receptor inhibition with haemoglobin, acute-phase reactants and iron metabolism markers (including hepcidin) in patients with rheumatoid arthritis (RA).
Data of patients receiving tocilizumab or placebo in the MEASURE study were analysed. We investigated associations at baseline and during tocilizumab treatment among haemoglobin, parameters of haemoglobin and iron homeostasis [ferritin, total iron-binding capacity (TIBC), hepcidin, haptoglobin], IL-6 and acute-phase reactants [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)] to identify statistical correlates of rise in haemoglobin level.
At baseline, CRP and haptoglobin were inversely correlated (modestly) with haemoglobin levels. After treatment with tocilizumab, CRP, hepcidin, ferritin and haptoglobin levels fell alongside increases in TIBC and haemoglobin. The falls in CRP, hepcidin and haptoglobin levels in the first 2 weeks correlated with a week 12 rise in TIBC and haemoglobin.
Inflammatory anaemia improves in patients with RA treated with tocilizumab. This improvement correlates with the degree of suppression of systemic inflammation, reduction in hepcidin and haptoglobin and increase in iron-binding capacity. These clinical data provide evidence of a role for IL-6 signalling in the inflammatory anaemia of RA.
我们的目的是确定类风湿关节炎（RA）患者中白细胞介素（IL）-6受体抑制与血红蛋白、急性期反应物和铁代谢标志物（包括铁调素）之间的相互关系。
分析了MEASURE研究中接受托珠单抗或安慰剂治疗的患者的数据。我们研究了血红蛋白、血红蛋白和铁稳态参数[铁蛋白、总铁结合力（TIBC）、铁调素、触珠蛋白]、IL-6和急性期反应物[C反应蛋白（CRP）、红细胞沉降率（ESR）]在基线和托珠单抗治疗期间的关联，以确定血红蛋白水平升高的统计相关性。
在基线时，CRP和触珠蛋白与血红蛋白水平呈负相关（轻度）。用托珠单抗治疗后，CRP、铁调素、铁蛋白和触珠蛋白水平下降，同时TIBC和血红蛋白升高。前2周CRP、铁调素和触珠蛋白水平的下降与第12周TIBC和血红蛋白的升高相关。
托珠单抗治疗的RA患者炎症性贫血得到改善。这种改善与全身炎症的抑制程度、铁调素和触珠蛋白的降低以及铁结合能力的增加相关。这些临床数据为IL-6信号在RA炎症性贫血中的作用提供了证据。
