Sikorska Dorota, Rutkowski Rafał, Łuczak Joanna, Samborski Włodzimierz, Witowski Janusz
Department of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland.
Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland.
Cent Eur J Immunol. 2018;43(3):289-294. doi: 10.5114/ceji.2018.80048. Epub 2018 Oct 30.
While adiponectin is typically viewed as an anti-inflammatory mediator, such an activity of adiponectin in rheumatoid arthritis (RA) is not so obvious. In the present study we examined whether serum levels of adiponectin reflect the clinical phenotype of RA patients and/or correlate with severity of the disease and the response to anti-TNF- therapy.
Twenty-one female RA patients qualified to receive anti-TNF- treatment were prospectively assessed before and after 12 weeks of therapy. Patients underwent full clinical and biochemical assessment. Disease activity was assessed by the Modified Disease Activity Scores (DAS28). Serum concentrations of adiponectin were measured with an immunoassay. The individuals were divided into two subgroups according to whether their baseline serum adiponectin was below or above the median value. The subgroups did not differ in basic demographic, anthropometric, and clinical parameters.
Anti-TNF- treatment resulted in a significant clinical (DAS28) improvement in patients from both subgroups, but no significant differences between basal and post-treatment serum adiponectin concentrations were observed. However, patients with higher baseline adiponectin experienced a significant and more pronounced improvement in laboratory parameters of inflammation (ESR, CRP, neutrophil count, neutrophil-to-lymphocyte ratio).
It is possible that adiponectin exerts systemic anti-inflammatory effects independently of the local activity of RA.
虽然脂联素通常被视为一种抗炎介质，但脂联素在类风湿关节炎（RA）中的这种活性并不那么明显。在本研究中，我们检测了脂联素的血清水平是否反映RA患者的临床表型和/或与疾病严重程度及抗TNF治疗反应相关。
对21名符合接受抗TNF治疗条件的女性RA患者在治疗前和治疗12周后进行前瞻性评估。患者接受了全面的临床和生化评估。通过改良疾病活动评分（DAS28）评估疾病活动度。采用免疫分析法测定血清脂联素浓度。根据患者基线血清脂联素水平是否低于或高于中位数将个体分为两个亚组。两个亚组在基本人口统计学、人体测量学和临床参数方面无差异。
抗TNF治疗使两个亚组患者的临床（DAS28）均有显著改善，但未观察到治疗前后血清脂联素浓度有显著差异。然而，基线脂联素水平较高的患者在炎症实验室参数（血沉、C反应蛋白、中性粒细胞计数、中性粒细胞与淋巴细胞比值）方面有显著且更明显的改善。
脂联素可能独立于RA的局部活动发挥全身抗炎作用。
