Autoantibody profile in rheumatoid arthritis during long-term infliximab treatment
Autoantibody profile in rheumatoid arthritis during long-term infliximab treatment
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DOI：
10.1186/ar1173
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发表时间：
2004-01-01
影响因子：
4.9
通讯作者：
Montecucco, C
中科院分区：
文献类型：
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作者：
Bobbio-Pallavicini, F;Alpini, C;Montecucco, C
本研究的目的是探讨长期英夫利西单抗治疗对类风湿关节炎患者各种自身抗体的影响。在基线和30周、54周和78周后检测了30例连续患者的血清样本，这些患者在英夫利西单抗和甲氨蝶呤治疗难治性类风湿关节炎期间进行了前瞻性随访。在这些时间点，疾病活动性评分的中位数分别为6.38（四分位距5.30-6.75）、3.69（2.67-4.62）、2.9（2.39-4.65）和3.71（2.62-5.06）。通过标准间接免疫荧光和/或ELISA评估各种自身抗体。最初，50%的患者抗核抗体阳性，78周后这一数字增加到80%（P=0.029）。IgG和IgM抗心磷脂抗体滴度的增加不太明显，但相似，而抗双链DNA抗体（ELISA法）的频率在54周时短暂升高（高达16.7%），在78周时下降至0%。蛋白酶3和髓过氧化物酶抗体未检出。基线和第78周时类风湿因子（RF）阳性的患者比例相似（分别为87%和80%）。然而，中位RF滴度从128 IU/ml（四分位数范围47-290 IU/ml）逐渐降低至53 IU/ml（18-106 IU/ml）。抗环瓜氨酸肽（CCP）抗体在治疗前83%的患者中发现;抗CCP抗体滴度在30周时显著下降，但此后恢复到基线水平。总之，抗双链DNA抗体的存在是一个短暂的现象，尽管抗核和抗心磷脂抗体的稳定增加。此外，在长期英夫利西单抗治疗期间，RF滴度和抗CCP抗体滴度的变化不同。
The aim of the present study was to investigate the effect of long-term infliximab treatment on various autoantibodies in patients with rheumatoid arthritis. Serum samples from 30 consecutive patients, who were prospectively followed during infliximab and methotrexate therapy for refractory rheumatoid arthritis, were tested at baseline and after 30, 54 and 78 weeks. At these points, median values of the Disease Activity Score were 6.38 (interquartile range 5.30-6.75), 3.69 (2.67-4.62), 2.9 (2.39-4.65) and 3.71 (2.62-5.06), respectively. Various autoantibodies were assessed by standard indirect immunofluorescence and/or ELISA. Initially, 50% of patients were positive for antinuclear antibodies, and this figure increased to 80% after 78 weeks (P=0.029). A less marked, similar increase was found for IgG and IgM anticardiolipin antibody titre, whereas the frequency of anti-double-stranded DNA antibodies (by ELISA) exhibited a transient rise (up to 16.7%) at 54 weeks and dropped to 0% at 78 weeks. Antibodies to proteinase-3 and myeloperoxidase were not detected. The proportion of patients who were positive for rheumatoid factor (RF) was similar at baseline and at 78 weeks (87% and 80%, respectively). However, the median RF titre exhibited a progressive reduction from 128 IU/ml (interquartile range 47-290 IU/ml) to 53 IU/ml (18-106 IU/ml). Anti-cyclic citrullinated peptide (CCP) antibodies were found in 83% of patients before therapy; anti-CCP antibody titre significantly decreased at 30 weeks but returned to baseline thereafter. In conclusion, the presence of anti-double-stranded DNA antibodies is a transient phenomenon, despite a stable increase in antinuclear and anticardiolipin antibodies. Also, the evolution of RF titres and that of anti-CCP antibody titres differed during long-term infliximab therapy.