Infliximab treatment reduces the serum levels of interleukin-23 in patients with rheumatoid arthritis

Abstract

In this study, we investigated the effect of the antitumor necrosis factor alpha (anti-TNF-alpha) antibody, infliximab, combined with methotrexate (MTX) and MTX alone on the serum levels of interleukin (IL)-23 and IL-17 in rheumatoid arthritis (RA) patients. Infliximab combined with MTX was administered to 26 patients with RA (infliximab group), and MTX alone was given to 20 patients with RA (MTX group). We evaluated clinical and laboratory parameters, including the Disease Activity Scores of 28 joints (DAS28) and serum levels of IL-23 and IL-17 at baseline and at 14 and 30 weeks after the initial treatment with these drugs. Single regression analysis was performed between the levels of serum IL-23 and other clinical and laboratory parameters at baseline before the initial treatment with infliximab or MTX. A significant reduction of DAS28 scores was observed in both the infliximab and the MTX group at 14 and 30 weeks after the initial treatment. A significant decrease in serum levels of IL-23 was observed in the infliximab group but not in the MTX group at 14 and 30 weeks after the initial treatment. Serum IL-17 levels did not show a significant change during the follow-up period. At baseline, before the initial treatment with infliximab or MTX, serum IL-23 levels showed a significant correlation with DAS28 and the number of swollen joints. This study indicated that the reduction of serum IL-23 levels in RA patients was a novel action of infliximab.

Anti-tumour necrosis factor therapy enhances mucosal healing through down-regulation of interleukin-21 expression and T helper type 17 cell infiltration in Crohn's disease

“…Our previous studies have also shown that IL-21 could promote LP-CD4 + T cells to differentiate into Th17 cells in CD patients [15]. Thus, the current results revealed a novel antiinflammatory activity of IFX by the reduction of IL-21 expression in the inflamed mucosa of CD patients, and the [29]. Evidence has shown that Th17 cells are identified as a potential subset of Th cells related to the development of autoimmunity and inflammatory responses such as CD, and that IL-21-driven intestinal pathology is associated with increased Th17 cell differentiation [30,31].…”

Enhanced and persistent levels of interleukin (IL)-17+CD4+ T cells and serum IL-17 in patients with early inflammatory arthritis

“…These data suggest that Th17 cells are involved in inflammatory arthritis, regardless of disease stage or treatment, although treatment effects (both increases and decreases) have been observed in other studies [3,[25][26][27][28].…”

Methotrexate attenuates the Th17/IL-17 levels in peripheral blood mononuclear cells from healthy individuals and RA patients

“…The diminution of IL-17 may be one of the mechanisms of MTX treatment in RA. Previous studies [26,27] have reported that there was no significant difference of serum IL-17 levels between predrug treatment and postdrug treatment. This may be caused by the complex interactions of drugs when MTX is used in combination with other drugs in vivo.…”