Madej A, Okopień B, Kowalski J, Zieliński M, Wysocki J, Szyguła B, Kalina Z, Herman Z
Zakład Farmakologii Klinicznej Katedry Farmakologii Slaskiej Akademii Medycznej w Katowicach.
Pol Arch Med Wewn. 1998 Apr;99(4):308-13.
Tumor necrosis factor alpha (TNF alpha) secreted by activated macrophages stimulates proliferation and migration of vascular smooth muscle in atherogenesis. Up to now, the effect of fibrates on concentration of TNF-alpha has not been investigated. The aim of this study was to estimate TNF-alpha plasma concentration in healthy subjects before and after fenofibrate therapy in patients with hyperlipoproteinaemia IIb and to correlate their levels with plasma concentration of total cholesterol (TC), low density lipoproteins (LDL) and apolipoprotein B (ApoB).
10 patients with hyperlipoproteinaemia IIb were treated with micronized fenofibrate (Lipanthyl 200 m-Fournier) for 1 month. Cytokines levels before and after therapy was measured by the ELISA method with Genzyme kits.
The levels of lipid parameters at the onset study were as follows: TC: 265.4 +/- 9.4 mg%, TG: 344 +/- 53 mg%, LDL: 167.2 +/- 4.7 mg%, and ApoB: 1.62 +/- 0.05 g/l. After 1-month therapy with Lipanthyl 200 m the parameters decreased: TC 206 +/- 16 mg% (p < 0.05), TG: 194 +/- 30 mg% (p < 0.05), ApoB: 1.43 +/- 0.04 g/l (p < 0.01), and LDL: 144.4 +/- 12.9 mg% (ns). The decreased level of TC, TG and LDL correlated with the decreased concentration of TNF alpha. Before treatment the TNF concentration was 19.2 +/- 1.6 pg/ml and was higher than the concentration of control subjects (9.9 +/- 1.1 pg/ml, p < 0.01). After 1-month therapy the level of TNF alpha in blood from patient was 9.2 +/- 1.0 pg/ml (p < 0.01). The results of this study indicate that the concentrations of TNF alpha in plasma from hyperlipidemic patients are higher than concentrations of healthy subjects. Fenofibrate decreased the levels of this cytokine. This effect may be of significance for the treatment of HLPIIb and of atherosclerosis prevention.
活化巨噬细胞分泌的肿瘤坏死因子α（TNFα）在动脉粥样硬化形成过程中刺激血管平滑肌的增殖和迁移。到目前为止，贝特类药物对TNF-α浓度的影响尚未得到研究。本研究的目的是评估IIb型高脂蛋白血症患者在非诺贝特治疗前后健康受试者的TNF-α血浆浓度，并将其水平与总胆固醇（TC）、低密度脂蛋白（LDL）和载脂蛋白B（ApoB）的血浆浓度相关联。
10例IIb型高脂蛋白血症患者接受微粒化非诺贝特（力平之200毫克，Fournier公司生产）治疗1个月。治疗前后的细胞因子水平采用Genzyme试剂盒通过ELISA法测定。
研究开始时的血脂参数水平如下：TC：265.4±9.4毫克%，TG：344±53毫克%，LDL：167.2±4.7毫克%，ApoB：1.62±0.05克/升。使用力平之200毫克治疗1个月后，这些参数降低：TC为206±16毫克%（p<0.05），TG：194±30毫克%（p<0.05），ApoB：1.43±0.04克/升（p<0.01），LDL：144.4±12.9毫克%（无统计学意义）。TC、TG和LDL水平的降低与TNFα浓度的降低相关。治疗前TNF浓度为19.2±1.6皮克/毫升，高于对照组受试者的浓度（9.9±1.1皮克/毫升，p<0.01）。1个月治疗后，患者血液中TNFα水平为9.2±1.0皮克/毫升（p<0.01）。本研究结果表明，高脂血症患者血浆中TNFα的浓度高于健康受试者。非诺贝特降低了这种细胞因子的水平。这种作用可能对IIb型高脂蛋白血症的治疗和动脉粥样硬化的预防具有重要意义。
