Monocyte migration to the synovium in rheumatoid arthritis patients treated with adalimumab
Monocyte migration to the synovium in rheumatoid arthritis patients treated with adalimumab
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DOI：
10.1136/ard.2010.141549
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发表时间：
2011-06-01
影响因子：
27.4
通讯作者：
Tak, P. P.
中科院分区：
文献类型：
--
作者：
Herenius, M. M. J.;Thurlings, R. M.;Tak, P. P.
目的肿瘤坏死因子阻滞剂治疗类风湿关节炎(RA)的作用机制尚不完全清楚。本研究的目的是测试阿达单抗治疗是否会影响单核细胞进入滑膜。方法采用一种新的技术分析标记的自体单核细胞在阿达单抗治疗前和治疗后14天的迁移情况。从RA患者中分离出CD14单核细胞，采用磁激活细胞分选阳性选择程序，并用technetium-99m-hexamethylpropylene-amino-oxime.标记结果阿达利单抗治疗14d后，28个关节的疾病活动度评分明显降低。结论阿达单抗治疗并不能减少单核细胞在治疗开始后早期进入滑膜。由于先前的研究表明，肿瘤坏死因子抗体治疗后巨噬细胞的浸润迅速减少，这不能用细胞死亡的增加来解释，这表明炎症细胞从滑膜外流的增加是一个重要的作用。
Objectives The mechanism of action of treatment with tumour necrosis factor (TNF) blockers in rheumatoid arthritis (RA) is still not completely understood. The aim of this study was to test if adalimumab treatment could affect the influx of monocytes into the synovium.Methods A novel technique was used to analyse the migration of labelled autologous monocytes before and 14 days after initiation of adalimumab treatment using scintigraphy. CD14 monocytes were isolated from patients with RA, using a positive selection procedure with magnetic-activated cell sorting, and labelled with technetium-99m-hexamethylpropylene-amino-oxime. Scintigraphic scans were made 1, 2 and 3 h after re-infusion.Results As early as 14 days after the start of treatment with adalimumab a significant decrease in disease activity score evaluated in 28 joints was shown. There was no significant decrease in the influx of monocytes into the joint at this time.Conclusions This study indicates that adalimumab treatment does not reduce the influx of monocytes into the synovium early after initiation of treatment. As previous studies showed a rapid decrease in macrophage infiltration after TNF-antibody therapy, which could not be explained by increased cell death, this points to an important role for enhanced efflux of inflammatory cells from the synovium.