Interleukin 17F Level and Interferon Beta Response in Patients With Multiple Sclerosis
Interleukin 17F Level and Interferon Beta Response in Patients With Multiple Sclerosis
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DOI：
10.1001/jamaneurol.2013.192
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发表时间：
2013-08-01
期刊：
影响因子：
29
通讯作者：
Pohl, Christopher
中科院分区：
文献类型：
--
作者：
Hartung, Hans-Peter;Steinman, Lawrence;Pohl, Christopher
在复发-缓解型多发性硬化症患者中，血清白细胞介素17F （IL-17F）基线水平高与对干扰素β的次优反应相关。目的：利用Singulex Erenna IL-17F免疫测定法，进一步研究IL-17F在预测复发缓解型多发性硬化症患者对干扰素β -lb治疗反应中的作用。设计、环境和患者：在一项新剂量干扰素疗效研究中，对239名随机选择的接受β -lb （250 μ g）干扰素治疗至少2年的患者的血清样本进行分析。干扰素-lb治疗，250 μ g，至少2年。主要结局指标：比较基线和第6个月时的IL-17F水平以及第6个月和基线时IL-17F水平的差异：(1)疾病活动度较低的患者与疾病活动度较高的患者；(2)无疾病活动性vs有疾病活动性；(3)反应者和无反应者。结果：根据临床和磁共振成像标准，在基线和第6个月测量的IL-17F水平与2年后对治疗缺乏反应无关。磁共振成像上的复发和新病灶与预处理血清IL-17F水平无关。当排除有中和抗体的患者时，结果没有改变。所有IL-17F水平大于200 pg/mL的患者均伴有不良的临床或放射活性。在使用干扰素治疗前和治疗后早期，IL-17F的升高与不良反应无关。这些数据不支持IL-17F作为多发性硬化症患者干扰素治疗反应指标的价值，尽管高于200 pg/mL的IL-17F水平可能预测无反应性。
IMPORTANCE High serum levels of interleukin 17F (IL-17F) at baseline have been associated with suboptimal response to interferon beta in patients with relapsing-remitting multiple sclerosis.OBJECTIVE To further investigate the role of IL-17F in predicting treatment response to interferon beta-lb in patients with relapsing-remitting multiple sclerosis using the Singulex Erenna IL-17F immunoassay.DESIGN, SETTING, AND PATIENTS Serum samples were analyzed from 239 randomly selected patients treated with interferon beta-lb, 250 mu g, for at least 2 years in the Betaferon Efficacy Yielding Outcomes of a New Dose Study.EXPOSURE Treatment with interferon beta-lb, 250 mu g, for at least 2 years.MAIN OUTCOME MEASURES Levels of IL-17F at baseline and month 6 as well as the difference between the IL-17F levels at month 6 and baseline were compared between the following: (1) patients with less disease activity vs more disease activity; (2) patients with no disease activity vs some disease activity; and (3) responders vs nonresponders.RESULTS Levels of IL-17F measured at baseline and month 6 did not correlate with lack of response to treatment after 2 years using clinical and magnetic resonance imaging criteria. Relapses and new lesions on magnetic resonance imaging were not associated with pretreatment serum IL-17F levels. When patients with neutralizing antibodies were excluded, the results did not change. All patients with levels of IL-17F greater than 200 pg/mL were associated with poor response with some clinical or radiological activity.CONCLUSIONS AND RELEVANCE An increase of IL-17F before and early after treatment with interferon beta-lb was not associated with poor response. These data do not support the value of IL-17F as a treatment response indicator for therapy of patients with multiple sclerosis with interferon beta, although high levels of IL-17F greater than 200 pg/mL may predict nonresponsiveness.