Adalimumab and infliximab of use inflammatory markers, cytokines and matrix metalloproteinase-3 levels effect in patient with rheumatoid arthritis and ankylosing spondylitis

Objective: We aimed to assess adalimumab(ADA) and infliximab(IFX) efficacy on the patients of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) by using erithrocyte sedimentation rate (ESR), C-reactive protein (CRP), interferon gamma (IF-γ), interleukin-1 beta (IL-1β), interleukin 6 (IL- 6), matrix metalloproteinase 3 (MMP-3).
Material and Method: Sixteen RA, 15 AS patients were enrolled to this study. ADA was used on the half of RA patients, IFX was used on the other half randomly. ADA was used on 7 AS patients and IFX was used on 8 AS patients randomly too. Blood samples were taken at the weeks of 0, 1, 4 and 12. ESR and CRP were calculated at the same time with controls. Blood samples were hidden at the -20°C to evaluate after.
Results: There wasn’t any significant difference between the groups of RA and AS patients in terms of ESH and CRP levels (p>0.05). IF-γ was found lower on both patient groups and IL-6 and IL-1β were not included statistical analysis due to the wide range of values. MMP-3 levels was found correlated with ESR and CRP levels in both treatment and patient groups. MMP -3 was more supressed at ADA treated group on AS patients according to the IFX group on AS patients significantly (p<0.05).
Conclusion: MMP-3 was significantly more depressed on ADA treated group of the AS patients according to IFX treated group. We think many similar studies that include more patients needs to be done to say ADA’s better efficacy than in AS patients. It can be said that MMP-3 is a stable marker to determine the activity of chronic inflammatory diseases and monitoring response to therapy according to the cytokines.

Romatoid artritli ve ankilozan spondilitli hastalarda adalimumab ve infiliksimab kullanýmýnýn inflamatuvar belirteçler, sitokinler ve matriks metalloproteinaz-3 düzeylerine etkisi

Amaç: Romatoid Artrit (RA) ve Ankilozan spondilitli (AS) hastalarda, Adalimumab (ADA) ve Ýnfliksimab (IFX) kullanýmý ile elde edilen etkinliðin eritrosit sedimentasyon hýzý (ESH), C reaktif protein (CRP), interferon gama (IF-γ), interlökin-1 beta (IL-1β), interlökin-6 (IL-6) ve matriks metalloproteinaz-3 (MMP-3) yönünden karþýlaþtýrýlmasý amaçlandý.
Gereç ve Yöntem: Çalýþmaya, 16’sý RA ve 15’i AS toplam 31 hasta alýndý. RA’li hastalarýn yarýsýna ADA, diðer yarýsýna ÝNFÝ, AS’li hastalardan 7’sine ADA 8’ine ÝNFÝ randomize olarak uygulandý. Hastalarýn 0., 1., 4. ve 12. haftalarda kan örnekleri alýndý. ESH ve CRP kontrollerle eþ zamanlý olarak çalýþýldý. IF-γ, IL-1β, IL-6 ve MMP-3 ölçümleri için serumlar -20°C’de takip sonunda çalýþýlmak üzere saklandý.
Bulgular: ESH ve CRP’ye göre yapýlan karþýlaþtýrmada RA ve AS’de gruplar arasýnda anlamlý farklýlýk saptanmadý (>0.05). IF-γ her iki hastalýkta tespit edilebilen düzeylerin altýnda olup, IL-6 ve IL-1β’nýn ölçülebilen serum seviyelerinin çok geniþ bir aralýkta daðýlmasý nedeniyle sitokinler her iki hastalýkta her iki ilaç grubunda istatistiksel deðerlendirmeye alýnamadý. MMP-3, her iki hastalýkta, her iki ilaç grubunda ESH ve CRP’ye benzer bir seyir gösterdi. Bununla birlikte MMP-3 özellikle AS’de ADA grubunda ÝNFÝ grubuna göre anlamlý olarak daha fazla baskýlandý (<0.05).
Sonuç: MMP-3’ün AS’de ADA grubunda IFX grubuna göre anlamlý olarak daha fazla baskýlandýðý görüldü. Fakat AS’de ADA’ýn etkinliðinin IFX’dan daha iyi olduðunun söylenebilmesi için bu yönde çok sayýda hastanýn yer alacaðý benzer çalýþmalarýn yapýlmasýna ihtiyaç vardýr. Bunun yanýnda MMP-3’in kronik inflamatuvar artritlerin hastalýk aktivitesini belirlemede ve tedaviye yanýtýn takibinde sitokinlere göre daha kararlý bir belirteç olabileceði söylenebilir.