抗瘤缩因子-α治疗改善了类风湿性关节炎患者的内皮功能
David Hürlimann1, Adrian Forster, Georg Noll
1Cardiology Department, University Hospital, Zürich, Switzerland.
Circulation
|October 23, 2002
概括
抗瘤坏死因子-α (TNF-α) 治疗与infliximab显著改善了风湿性关节炎 (RA) 患者的内皮功能和减少了疾病活性. 这表明TNF-alpha在RA相关的血管功能障碍中起着关键作用.
科学领域:
- 心血管医学 心血管医学
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 类风湿性关节炎 (RA) 与加速动脉样硬化有关,增加心血管风险.
- 炎症过程在RA和动脉样硬化共享的相似之处,涉及细胞因子,如瘤坏死因子-α (TNF-α).
- 在动脉样硬化疾病的进展中,TNF-alpha与关节炎症和血管功能障碍有关.
研究的目的:
- 为了评估使用抗TNF-α抗体infliximab的慢性抗炎治疗的影响.
- 评估接受因弗利克西马布治疗的活跃RA患者的疾病活性和内皮功能变化.
主要方法:
- 研究了11名RA患者,尽管接受了甲索特雷克萨特和普雷迪尼松治疗,但患病活度很高.
- 通过手臂动脉血管扩张 (通过流量介导和尼甘氨酸诱导) 使用高分辨率超声波来评估内皮功能.
- 临床状态,包括疾病活性评分 (DAS28),红细胞沉积率 (ESR) 和C反应蛋白 (CRP),在12周的因弗力西马布治疗前后进行测量.
主要成果:
- 通过流体介导的血管扩张显著改善了因弗利克西马布治疗后的情况 (3.2%至4.1%,P=0.018).
- 内皮独立血管扩张和基线动脉直径保持不变.
- 疾病活动评分 (DAS28) 显著下降 (5.6至3.5,P=0.002),ESR和CRP下降的趋势.
结论:
- 这项研究表明,抗TNF-α治疗,特别是因弗利西马布,可以改善RA患者的内皮功能.
- 这些发现表明,RA中的内皮功能障碍是疾病过程中不可或缺的一部分.
- 鉴定TNF-α是这种TNF-α驱动的RA内皮功能障碍的关键调解者.
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