Eder Piotr, Korybalska Katarzyna, Łykowska-Szuber Liliana, Stawczyk-Eder Kamila, Krela-Kaźmierczak Iwona, Łuczak Joanna, Czepulis Natasza, Linke Krzysztof, Witowski Janusz
Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Poznan, Poland.
Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.
Dig Liver Dis. 2016 Oct;48(10):1168-71. doi: 10.1016/j.dld.2016.06.038. Epub 2016 Jul 15.
Soluble tumour necrosis factor-α (sTNF-α) has been reported to increase in the course of anti-TNF-α therapy for rheumatoid and skin diseases.
To assess changes in sTNF-α and clinical efficacy of anti-TNF-α agents in Crohn's disease (CD).
Sixty-four patients on infliximab or adalimumab were analyzed. Clinical outcomes were assessed by using CD Activity Index after the induction therapy and at week 52. sTNF-α was measured before and after the induction therapy with high-sensitivity immunoassay.
In the majority of patients, sTNF-α increased significantly. Those with the greatest increase were more likely to experience long-term response, were more often treated with infliximab, had less frequently isolated small bowel CD, and tended to have sTNF-α levels at baseline that correlated with C-reactive protein.
Neutralization of sTNF-α does not seem to be critical for the efficacy of anti-TNF-α therapy in CD. Paradoxically - an increase in sTNF-α may reflect an ongoing process that is beneficial for the clinical outcome.
据报道，在类风湿性疾病和皮肤病的抗TNF-α治疗过程中，可溶性肿瘤坏死因子-α（sTNF-α）会升高。
评估克罗恩病（CD）患者中sTNF-α的变化以及抗TNF-α药物的临床疗效。
对64例接受英夫利昔单抗或阿达木单抗治疗的患者进行分析。在诱导治疗后及第52周时，使用CD活动指数评估临床结局。采用高灵敏度免疫分析法在诱导治疗前后测量sTNF-α。
大多数患者的sTNF-α显著升高。升高幅度最大的患者更有可能获得长期缓解，更多接受英夫利昔单抗治疗，孤立性小肠CD的发生率更低，且基线时sTNF-α水平往往与C反应蛋白相关。
sTNF-α的中和作用似乎对CD的抗TNF-α治疗疗效并非至关重要。矛盾的是，sTNF-α升高可能反映了一个对临床结局有益的持续过程。
