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EBSCO

https://doi.org/10.14300/mnnc.2016.11019

Serum concentration of immune, endocrine and endothelial biomarkers in patients with rheumatoid arthritis associated with different variants of metabolic status treated with Infliximab

[Original research] [Internal diseases]
Sergey Oranskiy; Lyudmila Yeliseyeva;

Aim of the study: Evaluation the effect of infliximab (I) on traditional indicators of activity and several cytokine, hormonal and endothelial serum biomarkers in patients with rheumatoid arthritis (RA) with different types of metabolic status.

Material and Methods. 37 patients with RA (30 women and 7 men) with DAS28 index 7.2–7.4 (associated with normal body mass index – BMI, obesity and cachexia) treated with I and methotrexate were included in this study. In all patients we determined traditional markers of RA activity (DAS28, ESR, C-reactive protein) and serum biomarkers – tumour necrosis factor-α (TNF-α), interleukins-6, 10 (IL-6, IL-10), adiponectin, vascular endothelial growth factor (VEGF), cortisol using enzyme linked immunosorbent assay.

Results. In all patients we found high activity of RA traditional markers and high levels of TNF-α, IL-6, VEGF before I started. Low initial levels of adiponectin and high levels of cortisol we found in patients with RA associated with obesity. After 22 weeks of I course we determined decreasing of traditional RA markers and TNF-α, IL-6, VEGF in patients with normal BMI. In patients with RA and obesity we found increasing of adiponectin concentration from 2.1 (0.8–3.9) ng/ml to 5.8 (4.9–7.7) ng/ml, decreasing of high TNF-α initial level and no reduction of high IL-6 initial level.

Conclusions. Thus, we have found that in general, infliximab therapy may be effective in any variants of metabolic status in patients with RA through beneficial effect with correction of most traditional and serum biomarkers. Because obese patients present a more pronounced pro-inflammatory activation and decreased adiponectin effectiveness of the biological therapy may be reduced in this group.

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Keywords: rheumatoid arthritis, obesity, cytokines, endothelial dysfunction, biomarkers