Xu Yunzhi, Zhu Qi, Song Jinglve, Liu Hongli, Miao Yutong, Yang Fan, Wang Feiyan, Cheng Wenjing, Xi Yebin, Niu Xiaoyin, He Dongyi, Chen Guangjie
Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
Guanghua Integrative Medicine Hospital, Shanghai 200052, China.
Mediators Inflamm. 2015;2015:356040. doi: 10.1155/2015/356040. Epub 2015 Dec 2.
To expand upon the role of iguratimod (T-614) in the treatment of rheumatoid arthritis (RA), we investigated whether the Th1, Th17, follicular helper T cells (Tfh), and regulatory T cells (Treg) imbalance could be reversed by iguratimod and the clinical implications of this reversal.
In this trial, 74 patients were randomized into iguratimod-treated (group A) and control (broup B) group for a 24-week treatment period. In the subsequent 28 weeks, both groups were given iguratimod. Frequencies of Th1, Th17, Tfh, and Treg were quantified using flow cytometry, and serum cytokines were detected by enzyme-linked immunosorbent assay. mRNA expression of cytokines and transcriptional factor were quantified by RT-PCR. The composite Disease Activity Score, erythrocyte sedimentation rate, and C-reactive protein were assessed at each visit.
The clinical scores demonstrated effective suppression of disease after treatment with iguratimod. In addition, iguratimod downregulated Th1, Th17-type response and upregulated Treg. Furthermore, the levels of Th1, Th17, and Tfh associated inflammatory cytokines and transcription factors were reduced after treatment with iguratimod, while the levels of Treg associated cytokines and transcription factors were increased.
为了进一步探讨艾拉莫德（T - 614）在类风湿关节炎（RA）治疗中的作用，我们研究了艾拉莫德是否能逆转Th1、Th17、滤泡辅助性T细胞（Tfh）和调节性T细胞（Treg）失衡以及这种逆转的临床意义。
在本试验中，74例患者被随机分为艾拉莫德治疗组（A组）和对照组（B组），治疗期为24周。在随后的28周里，两组均给予艾拉莫德。采用流式细胞术定量检测Th1、Th17、Tfh和Treg的频率，通过酶联免疫吸附测定法检测血清细胞因子。采用逆转录聚合酶链反应（RT - PCR）定量检测细胞因子和转录因子的mRNA表达。每次就诊时评估综合疾病活动评分、红细胞沉降率和C反应蛋白。
临床评分显示，艾拉莫德治疗后疾病得到有效抑制。此外，艾拉莫德下调Th1、Th17型反应并上调Treg。此外，艾拉莫德治疗后，Th1、Th17和Tfh相关的炎性细胞因子和转录因子水平降低，而Treg相关的细胞因子和转录因子水平升高。
