Ahmadi Hossein, Jamshidi Ahmad Reza, Mahmoudi Mahdi, Gharibdoost Farhad, Vojdanian Mahdi, Fattahi Mohammad Javad, Rastkari Noushin, Aghazadeh Zahra, Mirshafiey Abbas
Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Rheumatology Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Allergy Asthma Immunol. 2017 Oct;16(5):433-442.
The aim of this study was to investigate the effect of β-D-mannuronic acid (M2000) on hematological parameters in patients with active rheumatoid arthritis. This study was conducted on 25 patients with active rheumatoid arthritis (RA) (identifier: IRCT2014011213739N2). M2000 was administered orally for anemic and non-anemic RA patients at a dose of 500 mg twice daily for 12 weeks. The patients were permitted to continue the conventional treatments excluding NSAIDs. Blood samples were collected at baseline, 4 and 12 weeks after drug administration and were tested for hematological parameters. Moreover, serum levels of TNF-α and IL-6 were analysed before and after M2000 therapy compared to healthy controls using enzyme linked immunosorbent assay method. We found a significant increase in the count of red blood cells and also hemoglobin (Hb) concentration (0.9 g/dL) in anemic patients after 12 weeks of M2000 therapy (p<0.02 and p<0.01, respectively). Furthermore, our results showed an improvement in Hb level (0.45 g/dL) even in non-anemic patients who were treated by M2000 (p<0.04). The leukocytosis in RA patients, significantly decreased in both anemic and non-anemic patients after 12 weeks of M2000 therapy (p<0.02 and p<0.03, respectively). The percent of neutrophils significantly increased in anemic patients (p<0.01) while in non-anemic patients it significantly decreased after 12 weeks of M2000 therapy (p<0.01). The serum levels of IL-6 and TNF-α significantly decreased after 12 weeks of M2000 therapy (p<0.01 and p<0.04, respectively). M2000 improves hematological parameters in RA patients by its potent inhibitory effect on serum levels of TNF-α and IL-6.
本研究的目的是调查β-D-甘露糖醛酸（M2000）对活动期类风湿关节炎患者血液学参数的影响。本研究针对25例活动期类风湿关节炎（RA）患者开展（标识符：IRCT2014011213739N2）。对于贫血和非贫血的RA患者，口服M2000，剂量为500毫克，每日两次，持续12周。患者可继续进行除非甾体抗炎药外的常规治疗。在基线、给药后4周和12周采集血样，并检测血液学参数。此外，与健康对照相比，在M2000治疗前后使用酶联免疫吸附测定法分析血清TNF-α和IL-6水平。我们发现，M2000治疗12周后，贫血患者的红细胞计数和血红蛋白（Hb）浓度显著增加（分别为p<0.02和p<0.01）。此外，我们的结果显示，即使是接受M2000治疗的非贫血患者，其Hb水平也有所改善（0.45克/分升，p<0.04）。M2000治疗12周后，RA患者的白细胞增多症在贫血和非贫血患者中均显著降低（分别为p<0.02和p<0.03）。贫血患者的中性粒细胞百分比显著增加（p<0.01），而在非贫血患者中，M2000治疗12周后显著降低（p<0.01）。M2000治疗12周后，血清IL-6和TNF-α水平显著降低（分别为p<0.01和p<0.04）。M2000通过对血清TNF-α和IL-6水平的有效抑制作用改善RA患者的血液学参数。
