Suppression of rheumatoid factor (RF) production in rheumatoid arthritis (RA) has been variably attributed to the use of remittive agents per se or to clinical improvement associated with their use. There have been conflicting reports with regard to the influence of methotrexate (MTX) on serum RF levels in RA. We determined IgM-RF and IgA-RF levels in paired serum samples (obtained at study entry and completion) from RA patients enrolled in multicenter trials with the Cooperative Systematic Studies of Rheumatic Diseases program. After exclusion of the 14 IgM-RF-negative sera, there were samples from 30 MTX-treated patients and 52 placebo-treated patients. Changes in IgM-RF and IgA-RF levels were weakly associated with each other. Significant decreases in IgM-RF levels were observed in the MTX-treated patients, but not in the placebo group. These changes were most significant in the MTX-treated patients who improved clinically. There were significant decreases in IgA-RF levels at study completion among MTX-treated patients who had improved clinically and those who had not improved clinically, but not in the placebo group. The contributions of clinical improvement and MTX treatment to changes in serum IgM-RF and IgA-RF levels were examined using a logistic regression model. Changes in IgM-RF were strongly related to MTX treatment and, to a lesser extent, to clinical improvement; changes in IgA-RF were related only to MTX treatment. These results indicate that MTX treatment per se decreases both IgM-RF and IgA-RF levels, whereas clinical improvement correlates with decreased IgM-RF levels only.(ABSTRACT TRUNCATED AT 250 WORDS)

译文

:在类风湿关节炎(RA)中抑制类风湿因子(RF)的产生已被归因于使用释放剂本身或与使用它们相关的临床改善。关于甲氨蝶呤(MTX)对RA血清RF水平的影响,有相互矛盾的报道。我们通过风湿性疾病合作系统研究计划参加了多中心试验的RA患者的配对血清样本(在研究进入和完成时获得)中确定了IgM-RF和IgA-RF的水平。排除14种IgM-RF阴性血清后,有30名接受MTX治疗的患者和52名接受安慰剂治疗的患者的样本。 IgM-RF和IgA-RF水平的变化之间存在弱关联。在接受MTX治疗的患者中观察到IgM-RF水平显着降低,但在安慰剂组中未观察到。这些变化在经MTX治疗且临床上有所改善的患者中最为显着。在研究完成时,在临床上有所改善和在临床上没有改善的患者中,但在安慰剂组中,在研究结束时,IgA-RF水平显着降低。使用逻辑回归模型检查了临床改善和MTX治疗对血清IgM-RF和IgA-RF水平变化的贡献。 IgM-RF的变化与MTX治疗密切相关,在较小程度上与临床改善密切相关。 IgA-RF的变化仅与MTX治疗有关。这些结果表明,MTX治疗本身会降低IgM-RF和IgA-RF水平,而临床改善仅与IgM-RF水平降低相关(摘要截断为250个字)

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录