Reduction of urinary levels of pyridinoline and deoxypyridinoline and serum levels of soluble receptor activator of NF-kappaB ligand by etanercept in patients with rheumatoid arthritis
Reduction of urinary levels of pyridinoline and deoxypyridinoline and serum levels of soluble receptor activator of NF-kappaB ligand by etanercept in patients with rheumatoid arthritis
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DOI：
10.1007/s10067-008-0870-8
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发表时间：
2008-09-01
影响因子：
3.4
通讯作者：
Akira, Nagano
中科院分区：
文献类型：
--
作者：
Yasunori, Kageyama;Masaaki, Takahashi;Akira, Nagano
在类风湿关节炎（RA）患者中研究了可溶性TNF-α受体依那西普对骨代谢的影响。30例RA患者接受依那西普治疗，每周一次或两次，持续6个月以上。我们评估了临床和实验室参数，并在基线和依那西普初始治疗后3个月和6个月测量了吡啶啉（PYD）、脱氧吡啶啉（DPD）、I型胶原交联N端肽（NTX）的尿排泄水平，以及骨碱性磷酸酶（BAP）、骨保护素（OPG）和可溶性NF κ B配体受体激活剂（sRANKL）的血清水平。依那西普治疗导致RA症状改善，PYD和DPD尿排泄水平以及血清sRANKL水平降低，6个月时差异显著，依那西普初始治疗后3个月和6个月时血清BAP水平升高。治疗后3个月和6个月尿NTX和血清OPG水平无明显变化，但血清OPG水平与血清CRP水平呈负相关，提示RA炎症调节可能导致OPG的诱导产生。依那西普可能具有降低RA患者骨吸收标志物水平和增加骨形成标志物水平同时降低sRANKL形成的能力。
The effects of soluble TNF-alpha receptor, etanercept, on bone metabolism were investigated in patients with rheumatoid arthritis (RA). Thirty RA patients were administered etanercept once or twice a week for more than 6 months. We evaluated clinical and laboratory parameters and measured urinary excretion levels of pyridinoline (PYD), deoxypyridinoline (DPD), cross-linked N-telopeptides of type I collagen (NTX), and serum levels of bone alkaline phosphatase (BAP), osteoprotegerin (OPG), and soluble receptor activator of NF kappa B ligand (sRANKL) at the baseline and at 3 and 6 months after initial treatment with etanercept. Etanercept treatment resulted in an improvement of symptoms due to RA and in a reduction of urinary excretion levels of PYD and DPD as well as serum sRANKL levels, with a significant difference at 6 months, and an increase of serum BAP levels at 3 and 6 months after the initial treatment with etanercept. Urinary NTX and serum OPG levels did not show a significant change at 3 and 6 months after the initial treatment, but serum OPG levels did show a reverse correlation with serum CRP levels, suggesting that the regulation of inflammation in RA may result in an induction of OPG production. Etanercept may have the ability to reduce the levels of bone resorption markers and to increase the levels of a bone formation marker while reducing sRANKL formation in RA patients.