在接受Rituximab治疗的血清阳性类风湿性关节炎患者中,炎症是导致全身性骨质损失的原因
Mie Jin Lim1, Kyong-Hee Jung1, Seong-Ryul Kwon1
1Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea.
The Korean journal of internal medicine
|October 22, 2023
概括
对类风湿性关节炎 (RA) 进行的瑞图西马布治疗没有改变骨代谢. 虽然它改善了炎症,但一些患者的疾病活性增加与较高的RANKL水平相关,这表明潜在的骨质损失.
科学领域:
- 类风湿病学 类风湿病学
- 骨的新陈代谢 骨的新陈代谢
- 免疫学 免疫学 免疫学
背景情况:
- 类风湿性关节炎 (RA) 是一种自身免疫性疾病,其特征是系统性炎症.
- 血清阳性RA患者经常经历骨质损失,影响整体健康.
- 像Rituximab这样的B细胞枯竭疗法在骨代谢中的作用尚未完全理解.
研究的目的:
- 研究Rituximab对血清阳性类风湿性关节炎 (RA) 患者系统性骨代谢的影响.
- 评估Rituximab治疗后骨矿物质密度 (BMD) 和关键骨周转标记物的变化.
- 为了探索与Rituximab治疗的RA患者的疾病活性,炎症和骨代谢标志物之间的关系.
主要方法:
- 20名血清阳性RA患者接受了一轮rituximab.
- 根据疾病活性,患者被分为一个或两个治疗周期组.
- 监测了骨矿物质密度 (BMD) 和核因子卡帕-B连接体 (RANKL) 受体激活剂的血清水平.
主要成果:
- 接受第二次西马布疗程的患者在12个月后显示部BMD降低,血清RANKL增加.
- 相比之下,接受一轮治疗的患者保持了骨质量,血清RANKL水平下降.
- 疾病活动 (DAS28) 最初在两组中都得到改善,但在两周期组中恶化了12个月.
结论:
- 瑞图西马布在RA中的抗炎作用似乎没有改变系统性骨代谢.
- 增加的疾病活性和全身炎症可能会导致更高的RANKL水平,导致骨质损失.
- 需要进一步的研究,以了解雷图西马布,炎症和RA骨健康之间的复杂相互作用.
相关概念视频
Rheumatic Heart Disease I: Introduction
14
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
14
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
148
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
148
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
170
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
170
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
37
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
37
T Cell Types and Functions
1.0K
When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
1.0K
Bone Disorders
3.6K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.6K


