摘要
目的探讨重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白[rhTNFR:Fc,益赛普(etaner-cept)]治疗类风湿关节炎(RA)的免疫学机制,了解rhTNFR:Fc对RA患者血清中致炎及抗炎性细胞因子的作用,比较rhTNFR:Fc和甲氨蝶呤(MTX)对这些细胞因子作用的不同,为rhTNFR:Fc治疗RA提供进一步的实验依据。方法采用酶联免疫吸附试验(ELISA)检测RA患者rhTNFR:Fc治疗前后血清中白细胞介素(IL)-1"、IL-6、IL-10、肿瘤坏死因子(TNF)-!和干扰素(INF)-#浓度。观察rhTNFR:Fc对细胞因子的影响。结果&%RA患者血清中的炎性细胞因子TNF-!、INF-#、IL-1"、IL-6的水平均高于健康对照组,其中IL-6、INF-#、TNF-!的水平与健康对照组相比差异有统计学意义(P<0.01),抗炎性细胞因子IL-10的水平低于健康对照组,但两者相比差异无统计学意义(P>0.05)。&’rhTNFR:Fc治疗RA后血清中Th1型细胞因子TNF-!、INF-#、IL-1"、IL-6水平均明显降低(P<0.01),而Th2型细胞因子IL-10的水平明显提高(P<0.01)。&(RA患者血清中TNF-!水平与肿胀关节数及肿胀关节指数呈正相关(P<0.05)。&)对临床指标的分析表明,rhTNFR:Fc治疗RA疗效确切。结论rhTNFR:Fc可以降低RA患者血清中TNF-!、INF-#、IL-1"、IL-6的水平,同时升高IL-10水平;在抑制了Th1型细胞因子的同时,增强了Th2型细胞因子的效应,从而改善RA的病情。
Objective To determine the effect of recombinant human tumor necrosis factor receptorFc fusion protein （rhTNFR：Fc） treatment on the level of cytokines in rheumatoid arthritis （RA）. Method Thirty patients with RA were treated with rhTNFR：Fc （25 rag, twice a week） as monotherapy. The pro-inflammatory cytokines such as TNF-α、INF-γ、IL-1β、IL-6 and anti-inflammatory cytokines such as IL-10 were measured in RA sera pre-and post-24 weeks of therapy. Results The level of inflammaory cytokines of RA such as IL-6, TNF-α, INF-T were significantly higher than the healthy controls （P〈0.01）, respectively. The level of IL-1β was higher than the healthy controls, but had no significant difference between RA and control group （P〉0.05）. The level of TNF-α、INF-γ、IL-1β、IL-6 were significantly decreased after treated with rhTNFR：Fc （P〈0.01）. In contrast, IL-10 was remarkably increased （P〈0.01）. The pretreatment TNF-α level correlated to swollen joint counts and swollen joint index. Conclusion rhTNFR：Fc therapy may down-regulate the level of pro-inflammatory cytokines and up-regulate the level of anti-inflammatory cytokines, and there by decrease the Th1/ Th2 cytokine ratio.
出处
《中华风湿病学杂志》
CAS
CSCD
2006年第4期209-212,共4页
Chinese Journal of Rheumatology
