Use of anti-tumor necrosis factor biologics in the treatment of rheumatoid arthritis does not change human T-lymphotropic virus type 1 markers: a case series
Use of anti-tumor necrosis factor biologics in the treatment of rheumatoid arthritis does not change human T-lymphotropic virus type 1 markers: a case series
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DOI：
10.3109/14397595.2013.844389
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发表时间：
2015-01-01
影响因子：
2.2
通讯作者：
Okayama, Akihiko
中科院分区：
文献类型：
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作者：
Umekita, Kunihiko;Umeki, Kazumi;Okayama, Akihiko
抗肿瘤坏死因子（anti-TNF）生物制剂可有效治疗类风湿性关节炎（RA）;然而，目前尚不清楚这种治疗是否会促进恶性肿瘤（如淋巴瘤）的发展。人类嗜T淋巴细胞病毒1型（HTLV-1）是成人T细胞淋巴瘤（ATL）的病原体，在日本流行。假设存在许多HTLV-1阳性RA患者;然而，迄今为止还没有关于抗TNF生物制剂对HTLV-1阳性患者影响的报告。我们分析了两例RA患者对抗TNF生物制剂治疗的反应和HTLV-1标志物的变化。根据欧洲抗风湿联盟反应标准，这2例患者在抗TNF生物制剂（英夫利西单抗和依那西普）给药后60-96周未出现反应。没有观察到ATL的迹象，HTLV-1标志物，如前病毒载量和HTLV-1感染细胞的克隆性，在两种情况下都没有显着变化。因此，抗TNF生物制剂治疗不会诱导HTLV-1活化，尽管在这项有限的研究中，对RA的作用不如HTLV-1阴性患者有效。有必要在更多患者中进行进一步的长期研究，以阐明抗TNF生物制剂在HTLV-1阳性RA患者中的安全性和有效性。
Anti-tumor necrosis factor (anti-TNF) biologics are effective in the treatment of rheumatoid arthritis (RA); however, it is still not clear whether this treatment promotes the development of malignancies such as lymphoma. Human T-lymphotropic virus type 1 (HTLV-1), which is a causative agent of adult T-cell lymphoma (ATL), is prevalent in Japan. Many HTLV-1-positive patients with RA are assumed to exist; however, there have thus far been no reports on the effect of anti-TNF biologics on HTLV-1-positive patients. We analyzed the response to treatment with anti-TNF biologics and change of HTLV-1 markers in two cases of RA. The two cases showed no response based on the European League Against of Rheumatism response criteria 60-96 weeks after administration of anti-TNF biologics (infliximab and etanercept). No signs of ATL were observed and HTLV-1 markers, such as proviral load and clonality of HTLV-1-infected cells, showed no significant change in either of two cases. Therefore, treatment with anti-TNF biologics did not induce activation of HTLV-1, although the effect on RA was not as effective as in HTLV-1-negative patients in this limited study. Further long-term study with a greater number of patients is necessary to clarify the safety and efficacy of anti-TNF biologics in HTLV-1-positive patients with RA.