摘要
目的：研究环孢素A（ciclosporin A，CsA）联合甲氨蝶呤（methotrexate，MTX）治疗对类风湿关节炎（rheumatoid arthritis，RA）患者血清IL-17的表达影响，揭示CsA联合MTX治疗RA的作用机制。方法：收集83例RA经MTX单药或联合CsA治疗的新确诊患者，以及健康志愿者31例。MTX单药治疗组（41例）每周予以MTX（10~15 mg）；CsA联合MTX治疗组42例，予以CsA 3 mg/kg/d和MTX（10~15 mg）每周1次；观察和评价患者治疗3月后血清中IL-17的表达变化，以及与疾病活动度评分、RF、anti-CCP之间的关系。结果：两组RA患者治疗前血清IL-17表达均显著高于正常健康对照组（P〈0.001）。与治疗前相比，两组血清中IL-17表达均下降，但MTX单药治疗组无差异性（P=0.062），联合治疗组中IL-17表达显著性下降（P=0.016）。在MTX和CsA联合治疗组中，IL-17的变化值与anti-CCP（r=0.42，P=0.041）和DAS28（r=0.49，P=0.023）的变化值具有相关性。结论：CsA联合MTX治疗RA的机制与抑制IL-17的表达有一定关系。
Objective： To investigate the role of cyclosporin A （CsA） and methotrexate （MTX） combined therapy in modulation of serum IL-17 express in the patients with rheumatoid arthritis （RA）.Methods： 83 new patients with rheumatoid arthritis were collected, which consist of MTX monotherapy （41 cases） and combination of MTX and CsA therapy （42 cases）. hTe MTX dose was applied for 10~15 mg per week, and CsA was 3 mg/kg per day. hTe sera IL-17 expression was detected by ELISA before therapy and atfer 3 months treatment. In addition, disease activity index, RF and anti-CCP were also evaluated, and corelation between IL-17 and above clinical parameters were analyzed.Results：hTe levels of IL-17 in AR patients and healthy volunteers were analyzed. As compared with healthy control, AR patients have high level of IL-17 （P〈0.001）, two group AR patients has no difference. Interestingly, when compared with pre-treatment, the expression of IL-17 was signiifcantly decreased in AR patients with MTX and CsA treatment （P=0.016）, while MTX monotherapy has no considerable change （P=0.062）. In the MTX and CsA treated group, correlations between the difference of IL-17 and those of clinical 〈br〉 and laboratory parameters at baseline and 3 months from initial treatment showed significant correlation with anti-CCP （r=0.42,P=0.041） and DAS28 （r=0.49,P=0.023）.Conclusion：The mechanism of CsA and MTX combined therapy in the patients with rheumatoid arthritis might due to the inhibition of IL-17 expression.
出处
《临床与病理杂志》
CAS
2015年第8期1533-1536,共4页
Journal of Clinical and Pathological Research
