Blockade of intra-articular TNF in peripheral spondyloarthritis: Its relevance to clinical scores, quantitative imaging and synovial fluid and synovial tissue biomarkers

被引：37

作者：

Fiocco, Ugo ^{[1
]}

Sfriso, Paolo ^{[1
]}

Oliviero, Francesca ^{[1
]}

Lunardi, Francesca ^{[2
]}

Calabrese, Fiorella ^{[2
]}

Scagliori, Elena ^{[1
,2
]}

Cozzi, Luisella ^{[1
]}

Di Maggio, Antonio ^{[2
]}

Nardacchione, Roberto ^{[3
]}

Molena, Beatrice ^{[1
]}

Felicetti, Mara ^{[1
]}

Gazzola, Katia ^{[1
]}

Stramare, Roberto ^{[2
]}

Rubaltelli, Leopoldo ^{[2
]}

Accordi, Benedetta ^{[4
]}

Costa, Luisa ^{[5
]}

Roux-Lombard, Pascale ^{[5
,6
,7
]}

Punzi, Leonardo ^{[1
]}

Dayer, Jean-Michel ^{[8
]}

机构：

[1] Univ Padua, Dept Med, I-35128 Padua, Italy

[2] Univ Padua, Dept Med Diagnost Sci & Special Therapies, I-35128 Padua, Italy

[3] Abano Terme Gen Hosp, Leonardo Fdn, Dept Orthoped, Abano Terme, PD, Italy

[4] Univ Padua, Dept Pediat, Oncohematol Lab, I-35128 Padua, Italy

[5] Univ Naples Federico II, Dept Clin & Expt Med, Rheumatol Res Unit, Naples, Italy

[6] Univ Hosp Geneva, Immunol & Allergy Div, CH-1211 Geneva, Switzerland

[7] Univ Geneva, CH-1211 Geneva, Switzerland

[8] CMU, Fac Med, CH-1211 Geneva, Switzerland

来源：

JOINT BONE SPINE | 2013年 / 80卷 / 02期

关键词：

Peripheral spondyloarthritis; Intra-articular TNF blockade; Contrast-enhanced magnetic resonance imaging; Ultrasonography; Synovial fluid biomarker; Synovial tissue biomarkers; ANTITUMOR NECROSIS FACTOR; RHEUMATOID-ARTHRITIS; PSORIATIC-ARTHRITIS; ALPHA BLOCKADE; SERUM-LEVELS; ETANERCEPT; ULTRASOUND; THERAPY; INTERLEUKIN-6; EXPRESSION;

D O I：

10.1016/j.jbspin.2012.06.016

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objectives: This open-label study is based on a translational approach with the aim of detecting changes in the clinical condition as well as in imaging and synovial biological markers in both synovial fluid (SF) and synovial tissue (ST) in peripheral spondyloarthritis (SpA) patients following intra-articular (IA) blockade of TNF-alpha by serial etanercept injections. Methods: Twenty-seven SpA patients with resistant knee synovitis underwent four biweekly IA injections of etanercept (E) (12.5 mg). The primary outcome of Thompson's Knee Index (THOMP), and secondary outcomes of Knee Joint Articular Index (KJAI), C-reactive protein (CRP), HAQ-Disability Index (HAQ-DI), maximal synovial thickness (MST) according to ultrasonography (US) and contrast-enhanced magnetic resonance (C+MR) imaging, ST-CD45+ mononuclear cells (MNC) and ST-CD31+ vessels, IL-1 beta, IL-1Ra and IL-6 levels in SF were assessed at baseline and at the end of the study. Results: At the study end, clinical and imaging outcomes as well as ST and SF biological markers were significantly reduced compared to baseline. There were significant correlations between clinical, imaging and biological markers (CRP with either THOMP, or KJAI, or HAQ-DI or SF-IL-1Ra; US-MST with KJAI, ST-CD45+ with either THOMP, or KJAI, or ST-CD31+, or SF-IL-1 beta; SF-IL-6 with either THOMP, or KJAI, or SF-IL-1 beta, or IL-1Ra). Conclusions: The proof of concept study revealed early improvement either in local and systemic clinical scores, in synovial thickness measures by C+MR and US, or expression of synovial biological markers. CD45+, CD31+ in ST and IL-6 and IL-1 beta in SF may be considered potential biomarkers of the peripheral SpA response to IA TNF-alpha blocking. (C) 2012 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.

引用

页码：165 / 170

页数：6

共 41 条

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Interleukins 1β and 6 but not transforming growth factor-β are essential for the differentiation of interleukin 17-producing human T helper cells [J].