Alterations in Gytokine Profile and Dendritic Cells Subsets in Peripheral Blood of Rheumatoid Arthritis Patients before and after Biologic Therapy

摘要

Rheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic joint inflammation and continuous immune cell infiltration in the synovium. These changes are linked to inflammatory cytokine release, leading to eventual destruction of cartilage and bone. During the last decade new therapeutic modalities have improved the prognosis, with the introduction of novel biological response modifiers including anti-TNFα CTLA4Ig and, more recently, anti-IL6. In the present study we looked at the immunolog-ical effects of these three forms of therapy. Serum, obtained from patients with RA was analyzed for TNFα, IL6, IL10, IFNy, and VEGF, and in parallel, circulating plasmacytoid and myeloid dendritic cells (DC) were enumerated before and after three infusions of the respective biological treatments. After treatment with anti-IL6, we found a significant reduction of IL6 and TNFα levels and the percentage of both DC subsets decreased. Although the results did not reach statistical significance for anti-TNFα treatment, similar trends were observed. Meanwhile, CTLA4Ig therapy led to the reduction IFNy levels only. None of the treatments modified significantly VEGF or IL10 levels. These findings may explain why patients with RA improve more rapidly on IL-6 therapy than with the other two modalities.