インフリキシマブは,全身性血管炎における内皮機能不全を改善する:血管炎症のモデル
A D Booth1, D R W Jayne, R K Kharbanda
1Clinical Pharmacology Unit, University of Cambridge, Box 110, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK. tonybooth1@yahoo.co.uk
Circulation
|March 24, 2004
まとめ
抗中性子細胞プラズマ抗体関連全身性血管炎 (AASV) の全身性炎症は,内皮機能不全と関連しています. 抗腫瘍死滅因子アルファ (TNF-alpha) 治療は,この機能不全を効果的に逆転させ,炎症を軽減します.
科学分野:
- 心血管医学は,心臓血管医学である.
- 免疫学 免疫学とは
- レウマトロジーの病理学
背景:
- 内皮機能障害と全身性炎症は,心臓血管疾患のリスク要因の1つです.
- 臨床的炎症と内皮機能不全の関連性は不明である.
- 抗中性子細胞プラズマ抗体関連全身性血管炎 (AASV) は,このリンクを調査するためのモデルとして機能します.
研究 の 目的:
- AASVの炎症が内皮機能不全と関連しているという仮説を検証する.
- 抗腫瘍死滅因子アルファ (TNF-alpha) 治療が炎症誘発性内皮機能不全を逆転させることができるかどうかを判断する.
主な方法:
- 前腕プレチスモグラフィーは,14人のAASV患者と21人の対照群で内皮機能を評価するために使用されました.
- 内皮機能は,疾患活動スコア (BVAS) と炎症マーカー (CRP,IL-6,TNF-α) と相関していた.
- TNFα抑制療法 (インフリキシマブ) が内皮機能に与える影響を評価した.
主要な成果:
- AASV患者では,対照群と比較して,前腕の血流反応がアセチルコリン (ACh) に対して低下した (P=0.002).
- ナトリウムニトロプロシド (SNP) (P=0.3) に対する反応において有意な差異は認められなかった.
- インフリキシマブ治療は,単独投与 (P=0.03) であっても,ACH応答を有意に改善しました (P=0.004).
結論:
- システミック血管炎は,内皮機能の障害と関連しています.
- 抗TNF-α治療は,AASVの臨床寛解と炎症の減少につながります.
- 抗TNF-α療法により,AASV患者の内皮に依存する血管運動反応が改善されます.
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