Etanercept decreases synovial expression of tumour necrosis factor-α and lymphotoxin-α in rheumatoid arthritis
| Autor: | Petra Neregård, Anca I. Catrina, Shankar Revu, af Klint E, Marianne Engström, Akilan Krishnamurthy |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pathology Necrosis Biopsy Gastroenterology Receptors Tumor Necrosis Factor Etanercept Arthritis Rheumatoid Arthroscopy 0302 clinical medicine Image Processing Computer-Assisted Immunology and Allergy skin and connective tissue diseases Lymphotoxin-alpha 0303 health sciences Synovial Membrane Antibodies Monoclonal General Medicine Middle Aged Immunohistochemistry 3. Good health Treatment Outcome Rheumatoid arthritis Antirheumatic Agents Tumor necrosis factor alpha Female medicine.symptom medicine.drug musculoskeletal diseases Adult medicine.medical_specialty Immunology Inflammation 03 medical and health sciences Rheumatology Internal medicine medicine Humans 030304 developmental biology Aged 030203 arthritis & rheumatology business.industry Tumor Necrosis Factor-alpha medicine.disease Infliximab Lymphotoxin Immunoglobulin G business |
| Zdroj: | Scandinavian Journal of Rheumatology; Vol 43 |
| ISSN: | 1502-7732 |
| Popis: | Etanercept is an effective tumour necrosis factor (TNF)-α inhibitor drug with the unique ability to block not only TNF-α but also lymphotoxin (LT)-α, at least in vitro. We aimed to investigate the in vivo effect of etanercept on synovial expression of TNF-α and LT-α.Synovial biopsies from 12 rheumatoid arthritis (RA) patients started on etanercept and 11 RA patients started on infliximab were obtained at baseline and 8 weeks after treatment initiation. Synovial expression of TNF-α and LT-α was evaluated by immunohistochemistry followed by computer-assisted image analysis. Differences between paired samples were analysed by the Wilcoxon test and between groups by the Mann-Whitney test. A p-value0.05 was considered statistically significant.Six out of the 12 of the patients started on etanercept achieved an American College of Rheumatology (ACR)50 response. Macroscopic evaluation of the joints during arthroscopy revealed a significant decrease of local inflammation mainly in good ACR50 responders. Synovial expression of both LT-α and TNF-α decreased but the differences did not reach statistical significance at a group level. By contrast, a significant decrease in both LT-α and TNF-α was observed when only good ACR50 responders were analysed. Despite higher levels of baseline synovial TNF-α in the good responders, neither baseline LT-α nor TNF-α could predict clinical response after 8 weeks. A decreasing trend of the synovial levels of LT-α was also observed in good responders to infliximab, but the difference did not reach statistical significance.Etanercept treatment modulates the synovial expression of both TNF-α and LT-α in vivo, a mechanism that might partly explain its clinical efficacy in RA. |
| Databáze: | OpenAIRE |
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