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Interference of tumor necrosis factor inhibitor treatments on soluble tumor necrosis factor receptor 2 levels in rheumatoid arthritis

机译:肿瘤坏死因子抑制剂治疗对类风湿关节炎可溶性肿瘤坏死因子受体2水平的干扰

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ObjectiveSoluble Tumor Necrosis Factor Receptor II (sTNFR2) is used as a biomarker to study cardiovascular disease (CVD) in diverse populations. TNF inhibitors (TNFi's) are a common treatment for inflammatory conditions. The objective of this study was to examine whether TNFi use impacts measured sTNFR2 levels.MethodsWe studied blood samples from a cohort of RA patients with clinical data and high sensitivity-C-reactive protein (hsCRP) measurements. To assess for interference, we tested the entire cohort for the expected positive correlation between sTNFR2 and TNFi using Pearson correlations. We then performed Pearson correlations between sTNFR2 and TNFi and sequentially removed subjects on adalimumab, etanercept, and infliximab; if interference was occurring, no correlation would be observed between hsCRP and sTNFR2, and correlation would be restored by removing subjects on the treatment causing the interference.ResultsWe studied 190 subjects, 84.2% female, 73.4% anti-CCP positive. All subjects with sTNFR2 level exceeding measurable level were on etanercept. The expected positive correlation between hsCRP and sTNFR2 was not observed when assessing the entire cohort, r?=?0.05, p?=?0.51. However, the expected correlation was restored only after excluding subjects on etanercept, r?=?0.46, p?
机译:目的可溶性肿瘤坏死因子受体II(sTNFR2)被用作生物标志物,用于研究不同人群的心血管疾病(CVD)。 TNF抑制剂(TNFi)是炎性疾病的常见治疗方法。这项研究的目的是检查TNFi的使用是否会影响所测量的sTNFR2水平。方法我们通过临床数据和高敏感性C反应蛋白(hsCRP)测量研究了一组RA患者的血液样本。为了评估干扰,我们使用Pearson相关性测试了整个队列中sTNFR2和TNFi之间预期的正相关性。然后,我们在sTNFR2和TNFi之间进行了Pearson相关性研究,并依次移除了阿达木单抗,依那西普和英夫利昔单抗;如果发生干扰,则在hsCRP和sTNFR2之间不会发现相关性,并且通过去除引起干扰的治疗对象可以恢复相关性。结果我们研究了190名对象,女性84.2%,抗CCP阳性73.4%。 sTNFR2水平超过可测量水平的所有受试者均接受依那西普治疗。在评估整个队列时,未观察到hsCRP与sTNFR2之间的预期正相关,r≥0.05,p≥0.51。但是,仅在排除依那西普,r≥0.46,p≤0.0001且不接受阿达木单抗或英夫利昔单抗的受试者后,才恢复了预期的相关性。 sTNFR2的ELISA仅使用依那西普进行,并证明与sTNFR2直接结合。结论我们的数据确定了依那西普和TNFR2检测之间的干扰。在TNFi中,仅依那西普具有模仿TNFR2的TNF结合结构域。在依那西普为治疗选择的人群中设计使用sTNFR2的研究时,应考虑这些数据。

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