Nagy Arnold, Mosdosi Bernadett, Simon Diana, Dergez Timea, Berki Timea
Department of Paediatrics, University of Pecs, Medical School, Pecs, Hungary.
Department of Immunology and Biotechnology, University of Pecs, Medical School, Pecs, Hungary.
Front Pediatr. 2020 Dec 10;8:614354. doi: 10.3389/fped.2020.614354. eCollection 2020.
Juvenile idiopathic arthritis (JIA) is an umbrella term for seven distinct chronic immune-mediated diseases. Disease-modifying anti-rheumatic drugs (DMARD) are used to treat the underlying joint inflammation as well as extra-articular manifestations. Immunosuppression is a considerable side effect of the drugs. The main goal of this study was to investigate the effect of different JIA therapies on leukocyte subpopulations, which play a role in immune-defense. Three study groups were established. The first group consisted of JIA patients treated with methotrexate solely, the second one received a combination of methotrexate (MTX) and adalimumab (ADA). The control group was made up of the patients' healthy siblings. A total of 63 children were recruited. Fourty-one children with JIA and 22 healthy controls were included in the study. The absolute number of CD3+ T-cells was significantly elevated in patients treated with biological therapy compared to healthy controls (p2 = 0.017). In contrast, the number of CD56+ natural killer cells was significantly lower in children receiving biological therapy in comparison with healthy donors (p2 = 0.039). A significant alteration was also demonstrated between patients treated with MTX and MTX/ADA group concerning CD 19+ B-cells (p3 = 0.042). This is the first study that demonstrates significant alterations in the number of B-cells and T-cells with a relative decrease of NK-cell ratios in JIA patients receiving different DMARD therapy. NCT03833271. 21.01.2019.
幼年特发性关节炎（JIA）是七种不同的慢性免疫介导疾病的统称。改善病情抗风湿药（DMARD）用于治疗潜在的关节炎症以及关节外表现。免疫抑制是这些药物相当大的副作用。本研究的主要目的是调查不同的JIA治疗方法对在免疫防御中起作用的白细胞亚群的影响。设立了三个研究组。第一组由仅接受甲氨蝶呤治疗的JIA患者组成，第二组接受甲氨蝶呤（MTX）和阿达木单抗（ADA）联合治疗。对照组由患者的健康兄弟姐妹组成。共招募了63名儿童。41名JIA儿童和22名健康对照纳入研究。与健康对照相比，接受生物治疗的患者中CD3 + T细胞的绝对数量显著升高（p2 = 0.017）。相比之下，接受生物治疗的儿童中CD56 +自然杀伤细胞的数量与健康供体相比显著降低（p2 = 0.039）。在接受MTX治疗的患者和MTX/ADA组之间，关于CD19 + B细胞也显示出显著差异（p3 = 0.042）。这是第一项表明接受不同DMARD治疗的JIA患者中B细胞和T细胞数量有显著变化且NK细胞比例相对降低的研究。NCT03833271。2019年1月21日。
