Sato Shoko, Chiba Toshimi, Nakamura Shotaro, Matsumoto Takayuki
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan.
J Gastroenterol Hepatol. 2015 Oct;30(10):1467-72. doi: 10.1111/jgh.13008.
Infliximab is an established therapy for ulcerative colitis (UC). The aim of this study was to examine various serum cytokine levels and to identify possible markers predictive of therapeutic efficacy of infliximab for UC patients.
Twenty-one patients with moderately active UC were given intravenous infliximab (5 mg/kg) at 0, 2, and 6 weeks as induction therapy. The serum levels of 17 cytokines were determined using a Bio-Plex suspension array system before and 8 weeks after induction therapy. Partial Mayo score (PMS) and serum C-reactive protein levels were used for the determination of clinical activities at 0 and 8 weeks after the treatment. The overall therapeutic effect was determined at 26 weeks according to the PMS.
The median value of the PMS decreased significantly 8 weeks after the treatment (from 6 to 1.5, P < 0.05). However, C-reactive protein levels did not change significantly. Levels of serum interleukin (IL)-8 (P < 0.05) and macrophage inflammatory protein-1β (P < 0.005) significantly decreased 8 weeks after the induction. Serum levels of the other 15 cytokines did not change significantly. At 26 weeks, 13 of 20 patients (65%) were responders while 7 patients were non-responders. Levels of serum IL-6 at 8 weeks were significantly lower in responders than in non-responders (P < 0.05).
Serum IL-8 and macrophage inflammatory protein-1β seem to be sensitive markers for UC patients treated with infliximab, while IL-6 at 8 weeks after induction therapy may be predictive of subsequent response to infliximab.
英夫利昔单抗是治疗溃疡性结肠炎（UC）的一种成熟疗法。本研究旨在检测多种血清细胞因子水平，并确定可预测英夫利昔单抗对UC患者治疗效果的潜在标志物。
21例中度活动性UC患者接受诱导治疗，分别于第0、2和6周静脉注射英夫利昔单抗（5mg/kg）。在诱导治疗前及治疗8周后，使用Bio-Plex悬浮阵列系统测定17种细胞因子的血清水平。采用部分梅奥评分（PMS）和血清C反应蛋白水平来评估治疗0周和8周时的临床活动度。根据PMS在26周时确定总体治疗效果。
治疗8周后，PMS的中位数显著下降（从6降至1.5，P<0.05）。然而，C反应蛋白水平无显著变化。诱导治疗8周后，血清白细胞介素（IL）-8水平（P<0.05）和巨噬细胞炎性蛋白-1β水平（P<0.005）显著降低。其他15种细胞因子的血清水平无显著变化。在26周时，20例患者中有13例（65%）为缓解者，7例为未缓解者。缓解者在8周时的血清IL-6水平显著低于未缓解者（P<0.05）。
血清IL-8和巨噬细胞炎性蛋白-1β似乎是接受英夫利昔单抗治疗的UC患者的敏感标志物，而诱导治疗8周时的IL-6水平可能预测随后对英夫利昔单抗的反应。
