Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn's disease
Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn's disease
复制标题
DOI：
10.1111/apt.13058
复制
发表时间：
2015-03-01
影响因子：
7.6
通讯作者：
Taupin, D.
中科院分区：
文献类型：
--
作者：
Subramaniam, K.;Fallon, K.;Taupin, D.
背景 60% 的克罗恩病患者会出现由慢性炎症引起的肌肉萎缩或肌肉减少症。转录蛋白 NF-kappa B 通过 MyoD 转录减少肌肉形成，并通过蛋白水解增加肌肉分解。目的 TNF 是 NF-kappa B 的有效激活剂，抗 TNF 剂英夫利昔单抗 (IFX) 可以阻止 NF-kappa B 激活，以确定接受 IFX 治疗的克罗恩病患者是否会获得肌肉体积和力量。方法我们对成年克罗恩病患者进行了一项前瞻性、重复测量的队列研究急性疾病发作。指导患者不要改变饮食或活动。伴随药物保持稳定。在第 1 周（治疗前）、第 16 周（IFX 诱导后）和第 25 周（首次 IFX 维持剂量后），我们评估了（i）大腿中段解剖学股四头肌的 MRI 体积； (ii) 三种特定收缩速度下的最大同心股四头肌收缩强度； (iii) 通过经过验证的仪器 (IPAQ) 进行身体活动； (iv) 三天食物摄入量和成分记录（食物称重法）； (v)IL6的血清水平。 结果招募了19名患者(58%为女性；平均年龄33.2+/-10.7岁)。从基线（右，1505 cm(3)）到第 25 周（右，1569 cm(3)；P = 0.010），IFX 增加了双腿的肌肉体积。从基线（右侧 30 度/秒，184.8 Nm）到第 25 周（右侧 30 度/秒，213.6 Nm；P = 0.002），IFX 还增加了双腿的肌肉力量。肌肉体积增加与男性相关（P = 0.003）。肌肉体积和力量的显着增加与泼尼松龙的使用无关。第 25 周血清 IL6 水平下降（P = 0.037）。结论抗 TNF 药物英夫利昔单抗可逆转克罗恩病患者的炎症性肌少症。
BackgroundMuscle wasting or sarcopenia arising from chronic inflammation is found in 60% of patients with Crohn's disease. Transcriptional protein NF-kappa B reduces muscle formation through MyoD transcription and increases muscle breakdown by proteolysis.AimAs TNF is a potent activator of NF-kappa B, and anti-TNF agent infliximab (IFX) prevents NF-kappa B activation, to determine whether or not Crohn's patients treated with IFX gain muscle volume and strength.MethodsWe performed a prospective, repeated-measures cohort study in adult Crohn's disease patients with an acute disease flare. Patients were instructed not to vary diet or activity. Concomitant medications were kept stable. At week 1 (pretreatment), week 16 (post-IFX induction) and week 25 (post-first IFX maintenance dose), we assessed (i) MRI volume of quadriceps femoris at anatomical mid-thigh; (ii) maximal concentric quadriceps contractions strength at three specific speeds of contraction; (iii) physical activity by validated instrument (IPAQ); (iv) Three-day food record of intake and composition (food-weighing method); (v) Serum levels of IL6.ResultsNineteen patients (58% female; mean age 33.2 +/- 10.7 years) were recruited. IFX increased muscle volume in both legs from baseline (right, 1505 cm(3)) to week 25 (right, 1569 cm(3); P = 0.010). IFX also increased muscle strength in both legs from baseline (right 30 degrees/s, 184.8 Nm) to week 25 (right 30 degrees/s, 213.6 Nm; P = 0.002). Muscle volume gain correlated with male gender (P = 0.003). Significant gains in muscle volume and strength were unrelated to prednisolone use. Serum IL6 levels decreased by week 25 (P = 0.037).ConclusionThe anti-TNF agent infliximab reverses inflammatory sarcopenia in patients with Crohn's disease.