Arvidson N G, Gudbjörnsson B, Elfman L, Rydén A C, Tötterman T H, Hällgren R
Department of Medicine, University Hospital, Uppsala, Sweden.
Ann Rheum Dis. 1994 Aug;53(8):521-4. doi: 10.1136/ard.53.8.521.
To test the hypothesis of a diurnal variation in circulating levels of interleukin-6 (IL-6) and/or tumour necrosis factor-alpha (TNF-alpha) in rheumatoid arthritis and other inflammatory connective tissue diseases.
Serum levels of IL-6 and TNF-alpha were measured at three hour intervals from 7:30 to 22:30 in 48 patients with different rheumatic diseases as well as ten healthy controls. In four of the patients with rheumatoid arthritis, serum IL-6 levels were measured before and after one week of treatment with prednisolone 15-20 mg daily.
IL-6 and TNF-alpha could not be detected in serum from healthy controls. However, serum IL-6 levels were substantially increased in patients with rheumatoid arthritis. Furthermore, patients with rheumatoid arthritis showed a statistically significant circadian variation in levels of IL-6. Peak values appeared in the morning and low values in the afternoon and evening. In contrast, levels were low and stable in other connective tissue diseases. Levels of TNF-alpha were low in patients with rheumatoid arthritis and high in patients with other connective tissue diseases, but without circadian rhythm. After treatment with prednisolone, levels of serum IL-6 decreased significantly, but the circadian rhythm remained.
The circadian rhythm of circulating IL-6 might correspond to the circadian rhythm of symptoms in rheumatoid arthritis. The diurnal variation of IL-6, and possibly other cytokines, might explain the conflicting results previously reported on the inter-relationship between circulating IL-6 levels and disease activity in rheumatoid arthritis.
检验类风湿关节炎及其他炎性结缔组织病中白细胞介素-6（IL-6）和/或肿瘤坏死因子-α（TNF-α）循环水平存在昼夜变化的假设。
对48例不同风湿性疾病患者以及10名健康对照者，从7:30至22:30每隔3小时测量血清IL-6和TNF-α水平。对4例类风湿关节炎患者，在每日服用15 - 20 mg泼尼松龙治疗1周前后测量血清IL-6水平。
健康对照者血清中未检测到IL-6和TNF-α。然而，类风湿关节炎患者血清IL-6水平显著升高。此外，类风湿关节炎患者的IL-6水平呈现出具有统计学意义的昼夜变化。峰值出现在早晨，下午和晚上值低。相比之下，其他结缔组织病中水平较低且稳定。类风湿关节炎患者TNF-α水平低，其他结缔组织病患者TNF-α水平高，但无昼夜节律。泼尼松龙治疗后，血清IL-6水平显著下降，但昼夜节律仍存在。
循环IL-6的昼夜节律可能与类风湿关节炎症状的昼夜节律相对应。IL-6以及可能其他细胞因子的昼夜变化，可能解释了先前报道的关于类风湿关节炎中循环IL-6水平与疾病活动之间相互关系的矛盾结果。
