在抗瘤坏死因子治疗期间下降疼痛调节的变化:在类风湿关节炎和脊髓关节炎的前性研究
Anne-Priscille Trouvin1, Arielle Simunek2, Joël Coste2
1Le Groupe Hospitalier Universitaire Paris Centre Cochin and Université Paris Cité, Paris, France, and Inserm U987, Université de Versailles Saint Quentin, Paris-Saclay University, AP-HP, Ambroise Paré Hospital, Boulogne-Billancourt, France.
Arthritis & rheumatology (Hoboken, N.J.)
|December 16, 2024
概括
瘤坏死因子抑制剂 (TNFi) 改善了类风湿性关节炎 (RA) 和脊椎关节炎 (SpA) 患者的下降疼痛调节. 这表明TNFi可能对炎症性类风湿性疾病中的中央疼痛通路产生积极影响.
科学领域:
- 类风湿病学 类风湿病学
- 疼痛医学 医学 疼痛医学
- 免疫学 免疫学 免疫学
背景情况:
- 类风湿性关节炎 (RA) 和脊椎关节炎 (SpA) 的持续性疼痛管理具有挑战性.
- 了解疼痛途径的改变和生物修饰性抗风湿药物 (bDMARDs) 在这些疾病中的作用是有限的.
研究的目的:
- 评估活跃的RA和SPA患者的疼痛值和下降疼痛调制.
- 评估引入瘤亡因子抑制剂 (TNFi) 对这些疼痛通路的影响.
主要方法:
- 招募了100名bDMARD-naive患者,这些患者患有活跃的RA或SPA,开始TNFi.
- 在6个月内进行了定量感官测试,包括热疼痛值和条件疼痛调制 (CPM).
- 测量CPM效应是根据条件刺激后热疼痛值的变化.
主要成果:
- 在六个月的随访期间,热性疼痛值没有显著变化.
- 在TNFi启动后观察到CPM效应的显著改善 (P < 0.001).
- 较高的CPM效应与减少疼痛和实现缓解或低疾病活性相关.
结论:
- 在活性炎症性类风湿性疾病中,TNFi治疗改善了受损的下降疼痛调节.
- 这些发现表明TNFi可能会影响中心疼痛调节机制.
- 热性疼痛值没有受到TNFi治疗的显著影响.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
115
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...
115
Analgesia and Pain Management
496
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
496
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
141
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...
141
T Cell Types and Functions
947
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...
947


