Inflammatory and prothrombotic biomarkers in patients with rheumatoid arthritis: Effects of tumor necrosis factor-α blockade
Inflammatory and prothrombotic biomarkers in patients with rheumatoid arthritis: Effects of tumor necrosis factor-α blockade
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DOI：
10.1016/j.jaut.2008.07.002
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发表时间：
2008-09-01
影响因子：
12.8
通讯作者：
Cugno, Massimo
中科院分区：
文献类型：
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作者：
Ingegnoli, Francesca;Fantini, Flavio;Cugno, Massimo
目的：心血管（CV）风险增加是类风湿性关节炎（RA）的标志，主要与慢性全身炎症有关。由于炎症与凝血紊乱有关，两者都可能在增加CV风险中发挥作用。用肿瘤坏死因子（TNF）-α阻断剂治疗RA是有效的，可以减少局部和全身炎症，但关于其对凝血的影响的信息很少。因此，我们调查了炎症和凝血血浆生物标志物之前和之后英夫利西单抗治疗RA patients.Methods：我们研究了20例活动性RA和40名健康对照。患者在第0、2、6和14周接受稳定剂量的甲氨蝶呤（10 mg/周）和英夫利西单抗（3 mg/kg）治疗。在基线和第14周，我们测定：疾病活动评分（DAS-28），视觉模拟评分疼痛，红细胞沉降率（ESR），以及血浆C反应蛋白（CRP），TNF-α，白细胞介素（IL）-6，凝血酶原片段1 + 2（F1 + 2）和D-二聚体水平。相同的炎症和凝血参数进行了评估后1小时英夫利西单抗infliximab infusion in 10 patients.Results：在基线，ESR，CRP，TNF-α，IL-6，F1 + 2和D-二聚体水平显着高于RA患者比对照组（P = 0.0001）。英夫利西单抗治疗14周后，患者临床症状明显改善，ESR、CRP、IL-6、F1 + 2和D-二聚体水平下降（P = 0.001 ~ P = 0.008）。TNF-α、IL-6、F1 + 2和D-二聚体水平在输注英夫利西单抗后1h显著降低（P = 0.005）。这种联合作用可能是降低这些患者整体血栓形成风险的关键。(C)2008爱思唯尔有限公司保留所有权利。
Objective: increased cardiovascular (CV) risk is a rheumatoid arthritis (RA) hallmark and it has been mainly related to chronic systemic inflammation. Since inflammation is linked to coagulation perturbation, both may play a role in increasing CV risk. Treatment with tumor necrosis factor (TNF)-alpha blocking agents is effective in RA and reduces local and systemic inflammation but there is little information on its effect on coagulation. We therefore investigated inflammation and coagulation plasma biomarkers before and after infliximab treatment in RA patients.Methods: We studied 20 patients with active RA and 40 healthy controls. Patients were treated with: a stable dose of methotrexate (10 mg/week), and infliximab (3 mg/kg) at weeks 0, 2, 6 and 14. At baseline and week 14, we determined: disease activity score (DAS-28), visual analogue scale pain, erythrocyte sedimentation rate (ESR), and plasma levels of C-reactive protein (CRP), TNF-alpha, interleukin (IL)-6, prothrombin fragment 1 + 2 (F1 + 2) and D-dimer. The same inflammation and coagulation parameters were evaluated I h after infliximab infusion in 10 patients.Results: At baseline, ESR, CRP, TNF-alpha, IL-6, F1 + 2 and D-dimer levels were significantly higher in RA patients than in controls (P = 0.0001). After 14 weeks of infliximab treatment, there was a significant clinical improvement and ESR and CRP, IL-6, F1 + 2 and D-dimer level decrease (P = 0.001-P = 0.008). The levels of TNF-alpha, IL-6, F1 + 2 and D-dimer significantly decreased I h after infliximab infusion (P = 0.005).Conclusions: Infliximab decreases inflammation and coagulation biomarkers in RA patients. Such a combined effect may be pivotal in reducing the whole thrombotic risk in these patients. (C) 2008 Elsevier Ltd. All rights reserved.