Ishii O, Yamada H, Ohya S, Moriuchi E, Kase C, Ichikawa Y, Yamasaki K
Institute of Medical Science, Saint Marianna University School of Medicine, Kawasaki-city.
Ryumachi. 1997 Dec;37(6):810-5.
Pentoxifylline (POF) has been shown to have anti-inflammatory and immunomodulatory effects. including suppression of TNF-alpha production by activated macrophages, Th-1 response of T cells, and fibroblasts' proliferation and metalloproteinase production. Pentoxifylline was also reported to possess therapeutic properties in 50% of severe refractory RA in an open study. We experienced a 64 year-old man with seronegative RA, stage 2, class 3. He showed 23 swollen joints, 32 painful joints, ADL score 37/40, and ESR 135 mm/h. All these parameters were dramatically improved 3 weeks after administration of POF 300 mg/d and prednisolone 5 mg/d. Discontinuation of POF resulted in rapid exacerbation of RA. POF was restarted and the patient showed complete recovery from arthritis with normalization of ESR within 3 months and was maintained a complete remission for another 1 year. This case further supports a potential antirheumatic effect of POF on some patients with RA.
己酮可可碱（POF）已被证明具有抗炎和免疫调节作用。包括抑制活化巨噬细胞产生肿瘤坏死因子-α、T细胞的Th-1反应以及成纤维细胞的增殖和金属蛋白酶的产生。在一项开放性研究中，据报道己酮可可碱对50%的重度难治性类风湿关节炎具有治疗作用。我们接诊了一名64岁的男性，患有血清阴性类风湿关节炎，处于2期，3级。他有23个关节肿胀，32个关节疼痛，日常生活活动能力（ADL）评分为37/40，红细胞沉降率（ESR）为135毫米/小时。在给予每日300毫克己酮可可碱和5毫克泼尼松龙治疗3周后，所有这些参数都有了显著改善。停用己酮可可碱导致类风湿关节炎迅速加重。重新使用己酮可可碱后，患者的关节炎完全康复，ESR在3个月内恢复正常，并维持完全缓解状态达1年之久。该病例进一步支持了己酮可可碱对一些类风湿关节炎患者具有潜在抗风湿作用的观点。
