Influence of Infliximab on Cytokines Network and Markers of Bone Remodeling in Rheumatoid Arthritis Patients

Abstract

PurposeOur aim was to determine the effects of infliximab on bone mineral metabolism in rheumatoid arthritis (RA) patients and analyze the relationship between inflammatory markers of acute phase thought to play a major role in bone remodeling.Materials and Methods36 patients with established RA were investigated. All patients underwent physical examination and blood and urinary analysis at baseline, 2 weeks, 14 weeks, 6 months and 12 months after the initiation of treatment. The serum levels of: tumor necrosis factor alpha (TNF-alpha), tumor necrosis factor alpha receptor 1 (TNFR1), TNFR2, interleukin 6 (IL-6), IL-17, IL-23 and markers of bone remodeling such as osteocalcin (BGP), deoxypyridynoline (Dpd), and N-telopeptide of type I collagen (NTx) were measured by ELISA.ResultsThe results showed significant decrease of all the above cytokines levels in RA patients in comparison with those after 2 weeks of treatment. After 6 months, the markers of bone formation and resorption decreased compared to baseline values. We found positive correlation between the levels of NTx and the levels of IL-6, IL-17 and TNFR1, and between the levels of Dpd and IL-6 and Dpd and TNFR2, whereas negative correlation between BGP and IL-23. After 12 months the positive association was found at the BGP level and IL-6 as well as Dpd and the level of IL-6. We also observed a positive relation between Dpd and TNF-alpha and negative between BGP and TNFR1.ConclusionWe suggest that infliximab treatment may limit the risk of osteoporosis in RA patients.

Characterization of Serum Cytokine Profile in Predominantly Colonic Inflammatory Bowel Disease to Delineate Ulcerative and Crohn's Colitides

“…It could be advised that patients receiving these medications should not be mixed or compared with patients without any medications at all, as the immunosuppressive drugs may influence the cytokines level greatly. 117 Manufacturer and assay used. When analyzing the literature, introducing the limitations on manufacturer or assay type markedly reduced the number of observations for each cytokine, which obstructed any comparisons.…”

“…It could be advised that patients receiving these medications should not be mixed or compared with patients without any medications at all, as the immunosuppressive drugs may influence the cytokines level greatly. 117 …”

Effects of infliximab local injection on orthodontic tooth movement in diabetic rabbits: A histological study

“…The treatment with infliximab results in significant decrease in the inflammatory markers and inhibits bone destruction effectively. 8 Andrade et al 9 showed that TNF-α antagonist significantly reduce the number of osteoclastic cells and controlling the production of chemokines in nonhuman primate model after the use of the orthodontic appliance in Wild-type mice (WT)and TNF-RI deficient mice. This study was conducted to investigate the role of local infliximab (TNF-α antagonist) injection on the periodontium of orthodontically moved teeth in experimentally induced diabetic rabbits.…”

Biologics for Osteoporosis: Where Do We Stand?

“…This latter observation might explain the continuous increase over 5 years in BMD observed during treatment of postmenopausal osteoporosis with denosumab [27]. As osteopo-It has been suggested that infliximab treatment may limit the risk of osteoporosis in rheumatoid arthritis (RA) patients [33]. Low body mass index, early disease onset, high corticosteroid doses and, anti-TNF-α therapy are associated with increased risk of osteoporosis.…”