Luqmani R, Sheeran T, Robinson M, Richardson K, Winkles J, Emery P
Department of Rheumatology, Selly Oak Hospital, Birmingham, UK.
Clin Exp Rheumatol. 1994 Sep-Oct;12(5):503-8.
To determine the value of serial measurements of circulating cytokines in patients with rheumatoid arthritis in response to the introduction of disease modifying anti-rheumatic drugs (DMARDs).
A prospective 12-week study of 98 patients starting second line therapy with serial measurements of IL1 beta, IL2 receptor, IL6, TNF, and urinary neopterins as well as ESR, CRP and rheumatoid factor.
The markers of the acute phase response fell significantly with treatment as did the rheumatoid factor. IL-6 fell in certain sub-groups (significantly so after sulphasalazine SZP) of treated patients, but no other consistent change in circulating cytokine levels was demonstrated. Urinary neopterins rose with therapy.
The measurement of circulating cytokine levels in patients with rheumatoid arthritis is of limited benefit; macrophage function (as measured by urinary neopterins) is initially enhanced by DMARDs in patients with rheumatoid arthritis.
确定在类风湿性关节炎患者中，连续测量循环细胞因子对于引入改善病情抗风湿药物（DMARDs）的反应的价值。
一项针对98例开始二线治疗患者的前瞻性12周研究，连续测量白细胞介素1β（IL1β）、白细胞介素2受体、白细胞介素6（IL6）、肿瘤坏死因子（TNF）以及尿新蝶呤，同时测量红细胞沉降率（ESR）、C反应蛋白（CRP）和类风湿因子。
随着治疗，急性期反应标志物以及类风湿因子均显著下降。在接受治疗的患者的某些亚组中（柳氮磺胺吡啶治疗后显著下降）白细胞介素6下降，但循环细胞因子水平未显示出其他一致变化。尿新蝶呤随治疗升高。
测量类风湿性关节炎患者循环细胞因子水平的益处有限；在类风湿性关节炎患者中，DMARDs最初可增强巨噬细胞功能（通过尿新蝶呤测量）。
