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Vol. 5. Núm. 1.
Páginas 23-27 (Febrero - Febrero 2009)
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Vol. 5. Núm. 1.
Páginas 23-27 (Febrero - Febrero 2009)
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El bloqueo terapéutico del factor de necrosis tumoral disminuye la concentración sérica de interleucina 15 en pacientes con artritis reumatoide
The therapeutic blockade of TNF reduces serum levels of interleukin 15 in patients with rheumatoid arthritis
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Isidoro González-Álvaroa,
Autor para correspondencia
isidoro.ga@ser.es

Autor para correspondencia.
, Ana M. Ortiza, Eva G. Tomeroa, Alejandro Balsab, Javier Ortec, Pedro Sabando Suáreza, Rosario García-Vicuñaa
a Servicio de Reumatología, Hospital Universitario de La Princesa, Madrid, España
b Servicio de Reumatología, Hospital Universitario La Paz, Madrid, España
c Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España
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Resumen
Objetivo

Analizar el efecto de la terapia con agentes inhibidores del factor de necrosis tumoral (TNF) en la concentración sérica de interleucina 15 (IL-15) y determinar si los valores basales de ésta o su variación con el tratamiento predicen la respuesta clínica a los anti-TNF.

Pacientes y método

Se estudió a 75 pacientes con artritis reumatoide que iban a iniciar tratamiento con anti-TNF. Se recogieron muestras de suero previas y a los 3 meses de tratamiento. La concentración de IL-15 se cuantificó mediante enzimoinmunoanálisis. Tanto en la visita basal como en la final se recogieron parámetros clínicos y analíticos que permitieran calcular el DAS28. También se recogieron variables sociodemográficas y otras relacionadas con la enfermedad, como factor reumatoide, número de fármacos previos, etc. Se definió remisión como un DAS28 < 2,6 y respuesta clínica relevante, como una disminución del DAS28 > 1,2.

Resultados

La concentración de IL-15 se relacionó de forma significativa con un mayor uso de fármacos modificadores de la enfermedad durante el seguimiento de los pacientes. También se observó una disminución significativa de la IL-15 a los 3 meses de tratamiento con anti-TNF. Sin embargo, los valores basales de IL-15 y su disminución con el tratamiento no se relacionaron con la respuesta a los anti-TNF o la consecución de remisión clínica.

Conclusiones

Nuestros datos parecen confirmar los obtenidos in vitro, que indican que el TNF está implicado en la modulación de la expresión de IL-15. No obstante, la medición de la concentración sérica de IL-15 no parece ser de utilidad para seleccionar a los pacientes candidatos a terapia anti-TNF.

Palabras clave:
Artritis reumatoide
Citocinas
Antagonistas del TNF
Interleucina 15
Abstract
Objective

To analyze the effect of the TNF blocking agents (aTNF) on the serum levels of interleukin 15 (IL-15). To determine whether baseline IL15 serum levels or their response to aTNF therapy can predict the clinical response to this treatment.

Patients and method

We studied 75 patients suffering from rheumatoid arthritis that were selected to start aTNF therapy. Serum samples were obtained at baseline visit and after three months of aTNF treatment. Measurement of IL-15 serum concentration was performed through immune-enzyme assay. We collected the clinical and analytical parameters needed to calculate DAS28 both at baseline and final visit, as well as sociodemographic variables and other such as rheumatoid factor, previous disease modifying anti-rheumatic drugs (DMARD), etc. We defined remission as a DAS28 < 2.6 and clinical response when the decrease in DAS28 value was higher than 1.2.

Results

There was a significant correlation between IL-15 serum level and the number of previous DMARD. We also detected a significant decrease in the concentration of serum IL-15 after three months of treatment with aTNF. However, neither the baseline IL-15 serum level nor the decrease in the concentration of IL-15 were associated with a specific pattern of response to aTNF.

Conclusions

Our data seem to support previous in vitro findings suggesting that TNF is involved in the regulation of IL-15 expression. Nevertheless, the measurement of IL-15 serum levels does not seem to be a useful tool to select those patients that should be treated with aTNF therapy.

Keywords:
Rheumatoid Arthritis
Cytokines
TNF antagonists
IL-15
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Copyright © 2009. Elsevier España S.L. Barcelona
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