益心舒胶囊对急性冠脉综合征患者PCI术后炎症因子的影响

目的探讨益心舒胶囊对急性冠脉综合征（ACS）患者经皮冠状动脉介入（PCI）术后炎症因子的影响。方法将入选的66例ACS患者随机分为对照组和治疗组,对照组给予常规治疗,治疗组在常规治疗基础上加用益心舒胶囊。分别于服药前后观察血清超敏C-反应蛋白（hs—CRP）、白细胞介素6（IL-6）水平的变化。结果对照组治疗后血清hs—CRP、IL-6较治疗前略下降,但差异无统计学意义（P〉0．05）。治疗组治疗后血清hs—CRP、IL-6较治疗前显著降低（P〈0．05）。治疗组与对照组比较,治疗后血清hs—CRP、IL-6水平显著降低（P〈0．05）。结论益心舒胶囊可进一步降低PCI术后的炎症反应。     

炎性因子在慢性阻塞性肺疾病急性加重期的作用研究

目的探讨慢性阻塞性肺疾病急性加重（AECOPD）患者治疗前后血IL-10、IL-23、CRP等炎症因子的浓度变化及其与肺功能损害的相关性。方法采用EHSA分析50例AECOPD患者治疗前后血清IL-10、IL-23、C-反应蛋白，测PaO2、FEV1、FEV1／FVC％、外周血白细胞计数和中性粒细胞百分比，分析IL-10、IL-23、CRP与FEV1和FEV1／FVC％的相关性。结果在AE—COPD患者中，治疗前后IL-10浓度分别为（179．9±73．8pg／L）和（223．5±107．8pg／L），比对照组（364．3±160．2pg／L）低；治疗前后IL-23浓度分别为（189．4±103．7pg／L）和（177．2±103．2pg／L），均比对照组（89．7±64．4pg／L）高；治疗前后CRP浓度分别为（24．1±18．2mg／L）和（10．2±4．6mg／L），均比对照组（5．6±1．9mg／L）高；差异均有统计学意义。IL-10浓度与FEV1％、FEV1／FVC变化呈正相关（r=0．782，r=0．575，P〈0．05）；IL-23浓度与FEV1％、FEV1／FVC呈负相关（r=-0．586，r=-0．453，P〈0．05）；CRP浓度与FEV1％、FEV1／FVC呈负相关（r=-0．725，r=-0．643，P〈0．05）。结论AECOPD患者血IL-10浓度较对照缉低．而IL-23和CRP浓度较对照组高；血IL-10、IL-23和CRP的浓度与肺功能损害程度相关。     

肺炎支原体感染所致患儿咳嗽变异性哮喘与血清细胞因子的关系及临床意义

目的探讨肺炎支原体（MP）感染所致咳嗽变异性哮喘（CVA）与血清IL-10、可溶性白介素-2受体（sIL-2R）的关系及临床意义。方法测定MP感染所致CVA患儿20例、普通CVA患儿32例治疗前及治疗后1个月IL-10、sIL-2R水平,并与正常对照组比较。结果MP感染所致CVA组IL-10较正常对照组明显下降,差异有统计学意义（P〈0．01）;普通CVA组与正常对照组差异无统计学意义（P〉0．05）;治疗后两组与对照组比较差异无统计学意义。治疗前MP感染所致CVA组和普通CVA组患儿sIL-2R明显增高,与对照组比较差异有统计学意义（P值均〈O．05）;治疗后MP感染所致CVA组患儿sIL-2R下降不明显,普通CVA组患儿明显下降（P〉0．05）。MP感染所致CVA组的咳嗽缓解情况显著优于普通CVA组,但住院时间长于普通CVA组,差异具有统计学意义（P〈0．05）。结论sIL-2R增高显示细胞免疫功能受抑,IL-10在MP感染所致CVA患儿低水平,显示机体免疫失衡,与疾病恢复慢有关。     

谷氨酰胺对老年恶性梗阻性黄疸患者可溶性白细胞介素2受体的影响

目的 探讨免疫营养剂谷氨酰胺（Glutamine，Gin）对老年恶性梗阻性黄疸患者围手术期可溶性白细胞介素2受体（sIL-2R）的影响。方法 选择经手术治疗的老年恶性梗阻性黄疸患者30例，随机分为常规治疗组（R组）和谷氨酰胺组（G组）各15例，另取15例单纯性胆囊炎患者血清作为对照组（C组）。G组于术前1d至术后7d每日静脉补充丙氨酸谷氨酰胺注射液100ml，并分别于术前1d，术后7、14、21d采静脉血，采用ELISA法测定血清sIL-2R水平，观察组问的差别。结果 R组及G组slL-2R水平较C组明显升高（P〈0．01），术后7d时明显高于术前（P〈0．01），G组于术后14d时sIL-2R水平接近术前，而R组则于术后21d时达到术前水平，二者21d时sIL-2R水平差异显著（P〈0．01）。结论 谷氨酰胺能够降低梗阻性黄疸患者sIL-2R水平，改善机体免疫状态。     

细胞因子与老年重症肺部感染病原菌的关系探讨

目的 探讨细胞因子与老年人重症肺部感染病原菌的关系。方法 对20例健康老年人、79例ICU感染早期、感染控制后的老年重症肺部感染患者空腹采血，酶联免疫吸附（ELISA）法测定样本的白细胞介素2受体（IL-2R）、白细胞介素6（IL-6）、白细胞介素8（IL-8）、肿瘤坏死因子α（TNF-α）及C反应蛋白（CRP）的含量，并行冷凝集试验（CAT）排除支原体感染；同时细菌培养明确病原菌，评价细胞因子与老年重症肺部感染病原菌的关系。结果 血清IL-2R、IL-6、CRP水平革兰阴性菌（G^-）感染组、革兰阳性菌（G^-）感染组、真菌感染组分别为较对照组均明显增高（P〈0．01），差异有统计学意义；而感染组间比较差异无统计学意义（P〉0．05）。G^＋感染组的血清IL-8水平明显低于G^-感染组及真菌感染组（P〈0．01），但与对照组比较，差异无统计学意义（P〉0．05）。G^＋感染组血清TNF-α水平较对照组增高（P〈0．05），但不如G^-感染组、真菌感染组较对照组增高明显（P〈0．01）；G^＋感染组血清TNF-α水平与G^-感染组、真菌感染组比较显著低下（P〈0．05）。结论 老年重症肺部G^＋感染者血清IL-2R、IL-6、CRP显著升高，而TNF-α升高较轻，IL-8降低，G^-感染患者、真菌感染患者血清TNF-α、IL-2R、IL-6、IL-8、CRP均显著升高。老年肺部感染初期血清TNF-α、IL-8水平可以做为早期协助预测病原菌的指标。     

氯诺昔康超前镇痛对胃癌根治术患者血清IL-2、IL-10、sIL-2R的影响

目的观察氯诺昔康超前镇痛对胃癌根治术患者血清IL-2、IL-10、sIL-2R的影响,并探讨其临床意义。方法将45例择期行胃癌根治术患者随机分为3组,Ⅰ组术后以曲马多行自控静脉镇痛（PCIA）;Ⅱ组以氯诺昔康行PCIA;Ⅲ组在麻醉前和关腹时静推氯诺昔康8 mg,术后以曲马多行PCIA。分别于PCIA后8、12、24、48、72 h采用视觉模拟评分（VAS）判定镇痛效果,分别于麻醉前（T1）、切皮后90 min（T2）及术后24（T3）、48（T4）、72 h（T5）测定血清IL-2、IL-10、sIL-2R。结果三组PCIA后各时点VAS比较,P均〉0.05。三组血清IL-2从T2起均较T1显著下降（P均〈0.05）;血清IL-10从T3起均较T1显著升高（P均〈0.05）,Ⅰ、Ⅲ组T5时仍显著高于T1水平（P均〈0.05）,Ⅱ组则恢复至T1水平（P〉0.05）,与Ⅰ、Ⅲ组值相比较P均〈0.05;Ⅰ、Ⅱ组血清sIL-2R从T3起均较T1明显升高（P均〈0.05）,Ⅲ组此时与T1相比,P〉0.05,但明显低于Ⅰ、Ⅱ组（P均〈0.05）,T5时与T1相比,P〈0.05。结论氯诺昔康超前镇痛能降低胃癌根治术后患者血清IL-2、IL-10、sIL-2R水平,从而减少手术对机体免疫的影响,且不影响镇痛效果。     

联合IL-4突变体及IL-5可溶性受体α对支气管哮喘小鼠气道炎症的影响

目的观察联合应用IL4突变体（IL-4MT）及IL-5可溶性受体d（sIL-5Rα）对支气管哮喘（简称哮喘）小鼠气道炎症水平的干预。方法50只雌性BALB／c小鼠随机分为正常对照组、哮喘组、IL-4MT治疗组、sIL-5Rα治疗组、联合IL-4MT及sIL-5Rd治疗组（简称联合治疗组）。哮喘组和治疗组分别给予卵蛋白（OVA）致敏和激发。其中,IL-4MT治疗组、sIL-5Rα治疗组、联合治疗组分别于激发前30min腹腔注射IL-4MT100μg、sIL-5Rα100μg及IL-4MT、sIL-5Rα各100μg进行干预,正常对照组和哮喘组给予生理盐水代替。末次激发后收集BALF计数白细胞和嗜酸粒细胞（EOS）比例;HE染色观察肺组织病理变化;ELISA法测定各组BALF中IL4、IL5、嗜酸粒细胞趋化因子（Eotaxin）水平变化;末端脱氧核苷酸转移酶介导的d-UTP切口末端标记（TUNEL）法检测肺组织EOS凋亡情况。结果与正常对照组比较,哮喘组小鼠肺组织出现典型病理损害,EOS比例（t=-50．48,P〈0．001）、IL-4（t=-12．98,P〈0．001）、IL-5（t=-20．51,P〈0．001）、Eotaxin（t=-17．56,P〈0．001）水平均显著升高,EOS凋亡率（t=5．35,P〈0．001）显著下降;与哮喘组比较,各治疗组小鼠肺组织病理损害明显减轻,EOS比例（II,4MT治疗组t=27．4,P〈0．001;sIL-5Rα治疗组t=29．41,P〈0．001;联合治疗组t=37．25,P〈0．001）明显下降;Eotaxin（IL-4MT治疗组t=6．92,P〈0．001;sIL-5Rα治疗组t-4．96,P〈0．001;联合治疗组t=9．95,P〈0．001）水平明显下降;EOS凋亡率（IL-4MT治疗组t=-4．26,P〈0．001;sIL-5Rα治疗组t=-5．81,P〈O．001;联合治疗组t=-7．28,P〈0．001）明显增高;与单独治疗组相比,联合治疗组对炎症的缓解效果更为明显。结论联合IL-4MT及sIL-5Rα可明显降低哮喘小鼠IL-5、Eotaxin水平,减少肺部EOS的浸润和增加其凋亡,可以明显缓解哮喘气道炎症。     

心房颤动患者射频消融术前术后炎症因子IL-6、IL-8与hs-CRP的变化

目的观察心房颤动（AF）患者射频消融术前、术后1年不同时期相关炎症因子的变化,以及此种变化趋势对房颤复发的影响。方法：42名临床诊断AF的患者,于射频消融术前、术后1、3、9和12个月抽取外周血,通过酶联免疫吸附试验测定高敏C反应蛋白（hs-CRP）、白细胞介素（IL）．6和IL-8的浓度。20例同期体检健康人作为正常对照组。结果：射频消融术前,AF患者hs-CRP、IL-6和IL．8水平明显高于正常对照组（P〈0．05）。AF患者hs-CRP水平在术后1个月较术前有明显下降（P〈0．05）,术后3个月趋于稳定。AF组IL-6、IL-8水平在术后3个月明显上升（P〈0．05）,术后9个月均明显下降（P〈0．05）,术后12个月趋于稳定。AF术后3个月内早期复发者与未复发者比较IL-6、IL-8水平前者较后者明显升高（P〈0．05）;88％比例的患者在之后长期随访中未再发生AF。术后12个月晚期复发者与未复发者相比IL-6、IL-8水平无统计学差异。AF复发者与未复发者hs-CRP水平差异未达统计学意义。结论：AF患者较正常健康人炎症因子IL-6、IL-8与hs-CRP水平均明显增高。射频消融术本身短期内可影响炎症因子表达;AF的转归与炎症因子的长期变化有关。     

类风湿性关节炎早期患者IL-17水平与骨关节损害的相关性研究

目的研究类风湿性关节炎（RA）早期患者血清IL-17水平与骨关节损害的相关性。方法采用ELISA方法检测52例RA早期患者血清IL-17和抗环瓜氨酸多肽（抗CCP）抗体水平,用放射学方法评估关节损害程度,并与血沉、c-反应蛋白（CRP）、类风湿因子（RF）等指标进行相关性分析。结果RA早期患者血清IL-17高于健康对照者（P〈0．05）;IL-17随X线分期变化,x线分期越重,IL-17水平越高（P〈0．01或〈0．05）;RA早期抗CCP抗体阳性患者血清IL-17水平高于阴性患者（P〈0．05）,RF阳性与阴性患者血清IL-17比较无统计学意义（P〉0．05）;IL-17与晨僵、抗CCP抗体、CRP、RF呈正相关（P〈0．01或P〈0．05）,而与病程、关节痛数、血沉无相关性（P〉0．05）。结论IL-17与RA的骨关节损害有关,关节损害越重,IL-17越高。     

老年肺部感染患者IL—6、IL—8和TNF—α测定及其意义

目的探讨老年慢性阻塞性疾病(COPD)患者合并肺部感染时外周血细胞因子白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子(TNF-α)和可溶性白细胞介素2受体(sIL-2R)的变化,及其与感染的相互关系.方法采用ABC-HRP方法测IL-6,IL-8.双抗体夹心ABC-ELISA法检测TNF-α,双抗体夹心ELISA检测sIL-2R水平.分别检测了25名正常人(A组)、55例老年COPD合并肺部感染急性期(B组)、21例老年COPD合并肺部感染好转期(C组)患者外周血IL-6、IL-8、TNF-α和sIL-2R的水平.结果B组和C组的血sIL-2R水平均较A组明显升高(P＜0.01).而B组和C组的血sIL-2R水平比较,则无明显差异(P＞0.05).B组的血IL-6水平明显高于A组(P＜0.05).而C组IL-6水平虽高与A组,并且低于B组该值,无统计学上意义(P＞0.05).B组和C组的血IL-8水平均低于A组,但无统计学意义.3组之间TNF-α水平比较,以B组升高最显著,C组次之,分别与对照组比较均有显著差异,P分别＜0.01和0.05.B组与C组比较,也有显著差异(P＜0.05).结论细胞因子IL-6、TNF-α和sIL-2R水平与老年COPD合并肺部感染的严重程度有关,并且3者之间呈正相关.故对其监测,将有利于疾病的分期和活动情况的判断,可作为观察疗效和判断预后的可靠指标.     

白细胞介素-5、可溶性白细胞介素-2受体及一氧化氮与哮喘发病的关系

目的探讨白细胞介素-5(IL-5)、可溶性白细胞介素-2受体(sIL-2R)、一氧化氮(N())及嗜酸性粒细胞(EOS)在哮喘发病中的意义。方法对治疗前后的急性发作期、稳定期哮喘组及对照组血清II-5、sIL-2R和NO水平及EOS计数进行了研究。结果哮喘急性发作组血清IL-5、sIL-2R、NO及EOS水平均明显高于哮喘缓解期组与对照组。哮喘发作期IL-5与EOS呈显著正相关。哮喘急性发作期组治疗后sIL-2R及NO水平较治疗前显著降低，IL-5与EOS水平下降但无统计学意义。结论血清IL-5、sIL-2R、NO及EOS水平升高，与哮喘发作密切相关。     

川崎病患儿血清可溶性白细胞介素-2受体和白细胞介素-6的变化及意义

目的探讨血清可溶性白细胞介素-2受体(sIL-2R)和白细胞介素-6(IL-6)水平在川崎病(K D)患儿中的变化,及其在发病中的作用。方法采用酶联免疫吸附试验(ELISA)双抗夹心法测定血清sIL-2R和IL-6水平;利用德灵BN ProSpec特种蛋白分析仪检测血清超敏C反应蛋白(hs-CRP)水平。结果30例KD患儿大剂量丙种球蛋白静脉滴注前(静丙前)和滴注后(静丙后)血清slL-2R和hs-CRP水平与对照组比较差异均有统计学意义(P<0.01),静丙前和静丙后比较差异有统计学意义(P<0.01);静丙前KD患儿血清IL-6和对照组比较差异有统计学意义(P<0.01);KD患儿血清slL-2R与hs-CR P水平呈正相关(r=0.6,P<0.01),静丙前K D患儿血清IL-6和hs-CRP呈正相关(r=0.68,P<0.01)。结论血清IL-6和slL-2R参与了川崎病的发生,它们可作为判断预后、评估患儿免疫功能状况的参考指标。     

狼疮性肾炎患者血清IL-6和sIL-2R水平变化的检测

目的探讨狼疮性肾炎(LN)患者血清中白细胞介素(IL)-6和可溶性IL-2受体(sIL-2R)的水平变化及临床意义。方法利用酶联免疫吸附试验(ELISA)检测42例LN患者和40例正常健康人血清IL-6和sIL-2R的水平。结果活动期LN组患者IL-6和sIL-2R水平显著高于静止期LN组患者及正常对照组(P<0.01),静止期LN组患者IL-6和sIL-2R水平显著高于正常对照组,差异有显著性(P<0.01)。结论LN患者血清IL-6和sIL-2R显著升高,可能与LN的发生发展有关,并可作为病情及疗效判断的观察指标。     

白血病患者脑脊液中可溶性白介素—2受体、白介素—6水平的测定及其临床意义

目的　探讨可溶性白介素 2受体 (sIL 2R)、白介素 6 (IL 6 )在急性淋巴细胞性白血病(ALL)的脑脊液 (CSF)中的表达及意义。方法　用双抗夹心ELISA法测定 30例ALL患者CSF中sIL 2R、IL 6水平 ,并与 10名正常者进行对照。结果　ALL合并中枢神经系统白血病 (CNS L)组较CNS L已缓解及未合并CNS L组二者水平显著升高 (P <0 .0 1) ;CNS L已缓解组二者水平接近对照组 (P >0 .0 5 ) ;骨髓缓解及好转组二者水平低于治疗无效组。结论　监测二者水平变化有助于CNS L早期诊断、评估疗效及预后。     

急性冠脉综合征早期辛伐他汀治疗对血脂和炎症反应标记物的影响

目的　观察急性冠脉综合征 (ACS)早期辛伐他汀治疗对血脂和炎症反应标记物的影响及差异 ,探讨他汀类药物在ACS早期治疗中的作用。　方法　ACS住院患者 12 3例 ,入院后测定血浆甘油三酯 (TG)、总胆固醇(TC)、低密度脂蛋白胆固醇 (LDL C)、高密度脂蛋白胆固醇 (HDL C)、白细胞介素 6 (IL 6 )和C反应蛋白 (CRP)水平 ,然后随机分为辛伐他汀治疗组和非辛伐他汀治疗组。出院时重复测定上述指标。同期测定 15例慢性稳定性心绞痛 (CAP)患者和 15名健康者作对照比较。　结果　 1 ACS患者血浆TC、LDL C、IL 6、CRP显著高于健康者 (P <0 0 1) ,血浆LDL C、IL 6显著高于CAP患者 (P <0 0 1)。 2 出院与入院时比较 ,辛伐他汀组和非辛伐他汀组血浆IL 6、CRP显著降低 (P <0 0 1) ,出院时辛伐他汀组血浆IL 6、CRP也显著低于非辛伐他汀组 (P <0 0 1)。 3 据入院时血浆IL 6、CRP水平 ,把ACS患者分别分为IL 6、CRP高值组和低值组 ,出院与入院时比较 ,高值组和低值组血浆IL 6、CRP均显著降低 (P<0 0 1,P<0 0 1) ,但只有高值组 ,出院时辛伐他汀治疗者血浆IL 6、CRP显著低于非辛伐他汀治疗者 (P <0 0 1,P <0 0 5 )。　结论　ACS患者早期辛伐他汀治疗有明显抗炎症作用。     

Soluble interleukin-6 receptor as a prognostic factor in multiple myeloma

Interleukin-6 (IL-6) is a major growth factor for the clonal malignant plasma cells in multiple myeloma (MM). The effect of IL-6 may be enhanced by soluble IL-6 receptor (sIL-6R). As there is a clinical need for improved stratification of MM patients at diagnosis, we have studied the role of sIL-6R as a prognostic marker in 207 newly diagnosed MM patients. Serum sIL-6R concentration was above the upper reference limit in 47% of the patients at diagnosis. The concentrations of sIL-6R and two other prognostic factors, IL-6 and β-2 microglobulin (β2M), were all significantly higher in the patients who died within 3 years compared with those who survived. However, serum sIL-6R did not show linear correlation with IL-6 or β2M levels. In univariate logistic regression analysis sIL-6R was a significant predictor of 3-year mortality. Kaplan-Meier analysis showed that raised levels of sIL-6R were associated with shorter survival. When the patients were stratified into four groups according to their serum IL-6 and sIL-6R levels, the patients with normal serum levels of both parameters had clear survival benefit. As β2M was the most powerful prognostic factor in the multivariate analysis, the patients were also stratified according to their serum β2M and sIL-6R levels. The patients with raised levels of both β2M and sIL-6R had shorter survival than the patients in the other three groups. Thus, measurement of these parameters at diagnosis would help to stratify MM patients.     

Interleukin-6, soluble interleukin-2 receptor and soluble interleukin-6 receptor in the sera of patients with different histological patterns of rheumatoid synovitis

OBJECTIVE: The present study was conducted to investigate whether the serum levels of interleukin 6 (IL-6), soluble IL-2 receptor (sIL-2R) and sIL-6R are associated with the morphological appearance of rheumatoid arthritis (RA). METHODS: Using the ELISA technique we measured the IL-6, sIL-2R and sIL-6R concentrations in the serum of 34 patients with RA and 28 patients with osteoarthritis (OA). Histological analysis of synovial samples distinguished 2 types of rheumatoid synovitis. Twenty-one RA specimens presented diffuse infiltrates of mononuclear cells without any specific microanatomical organization. In remaining 13 samples the formation of lymphocytic follicles with germinal center-like structures was found. RESULTS: Serum levels of IL-6, sIL-2R and sIL-6R were elevated in patients with RA compared to the OA control group (p < 0.001, p < 0.001 and p < 0.05 respectively). Concentrations of IL-6 and sIL-2R were highest in the serum of RA patients with follicular synovitis in comparison to patients with diffuse synovitis (p < 0.001 and p < 0.01 respectively) and could distinguish RA patients with these two histological variants of the disease. Serum levels of IL-6 and sIL-2R correlated with markers of disease activity such as ESR and CRP levels. In addition, the clinical data suggest a more severe disease among RA patients with follicular synovitis. CONCLUSION: Distinct histological types of rheumatoid synovitis associated with unique serum concentrations of IL-6 and sIL-2R reflect levels of disease activity and confirm the concept of RA heterogeneity.     

Treatment with fluvastatin rapidly modulates, via different pathways, and in dependence on the baseline level, inflammation in hemodialysis patients

BACKGROUND: Hemodialysis (HD) patients are frequently in an elevated inflammatory state which is correlated to the atherosclerosis-related and overall morbidity and mortality in this population. Statins, beyond their antilipidemic effects, are also considered to have anti-inflammatory, immunomodulating and antioxidant properties. The individual response of HD patients to a short course of fluvastatin, the mechanisms involved in the immunomodulating and anti-inflammatory effects of this drug and the time interval to the appearance of these effects are investigated in this longitudinal study. METHODS: In a group of 51 HD patients, fluvastatin 40 mg/day was administered for 4 weeks. Serial measurements of the lipid profile, C-reactive protein (CRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), interleukin-10 (IL-10), and serum oxidized LDL (ox-LDL), were performed before, during, and after the treatment period. RESULTS: Total cholesterol was significantly reduced after 14 days of treatment with fluvastatin (from mean +/- SD 216.7 +/- 34.3 to 179.2 +/- 42.3 mg/dl, p < 0.001). IL-6 and ox-LDL were reduced on day 28 (p < 0.001 and p < 0.01, respectively) and IL-10 was increased on day 14 (p = 0.05); CRP did not change significantly during the treatment period while sIL-6R was increased on day 28 of fluvastatin administration (p < 0.05). In a subgroup of patients with CRP, IL-6, sIL-6R, and ox-LDL baseline serum values > or = the median and IL-10 < or = the median, CRP was reduced on day 28 of fluvastatin treatment (p < 0.01), IL-6 and ox-LDL were reduced earlier, on day 14 (p = 0.05 and p < 0.05, respectively) while sIL-6R did not change significantly during the treatment period. CONCLUSIONS: Treatment with fluvastatin rapidly modulates inflammation in HD patients. Enhancement of anti-inflammatory mechanisms and attenuation of the inflammatory and oxidative state contribute to this modulation. Patients in an elevated baseline inflammatory state respond more rapidly and effectively to the treatment. This immediate and multi-potent action of the statins could be clinically useful in acute atherosclerosis complications or in the treatment of chronic inflammation in HD patients.     

Clodronate treatment reduces serum levels of interleukin-6 soluble receptor in Paget's disease of bone

OBJECTIVE: Interleukin-6 (IL-6) and its soluble receptor (sIL-6R) stimulate osteoclast formation and activity. The primary cell abnormality in Paget's disease of bone (PDB) involves osteoclasts. Pagetic osteoclasts overproduce IL-6 and IL-6 receptor in vitro. In vivo, IL-6 serum levels are very high in the acute phase of PDB. The aim of this study was to evaluate the modification in the serum levels of IL-6, sIL-6R and osteotropic hormones (parathormone, 25OHD3 and 1,25(OH)2D3) as a in long-term response to clodronate treatment in patients with PDB. METHODS: 16 patients (8 females) with polyostotic PDB were studied. IL-6, sIL-6R and osteotropic hormones serum levels were evaluated in active PDB and after clodronate treatment (300 mg injected intravenously for 5 consecutive days). The sequential changes in total alkaline phosphatase (tALP) serum levels were used to assess the maximal pharmacological response to treatment. RESULTS: In untreated pagetic patients, mean serum levels of IL-6 (3.20+/-1.18 pg/ml) and sIL-6R (35.02+/-8.33 ng/ml) were significantly increased. Serum osteotropic hormone levels fell within the normal range. Eight weeks after treatment, the maximal pharmacological response to clodronate was associated with a significant reduction of sIL-6R serum levels in all patients, without a significant variation in serum IL-6 and osteotropic hormone levels. Moreover, we observed a correlation between lower sIL-6R serum levels before clodronate therapy and complete remission of PBD, defined as a decrease of tALP serum levels within the normal range. CONCLUSION: The decrease in serum sIL-6R levels could be one of the molecular mechanisms that play a role in the clinical response to clodronate treatment in PDB.     

Soluble interleukin 2 receptors in polymyalgia rheumatica/giant cell arteritis. Clinical and laboratory correlations.

Serum levels of soluble interleukin 2 receptors (sIL-2R) were measured in 21 patients with polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) prior to steroid treatment. These levels were significantly elevated in patients with PMR/GCA compared with healthy controls (p = 0.002). A significantly longer duration of morning stiffness (p = 0.005) was observed in patients with a high concentration of sIL-2R. A significant correlation was observed at diagnosis between sIL-2R and erythrocyte sedimentation rate (ESR) (p = 0.01) and between ESR and C-reactive protein (CRP) (p = 0.005). We investigated prospectively a group of 10 patients over a period of 6 months of prednisone therapy. At the end of the study sIL-2R levels fell significantly compared to pretreatment values (p = 0.02), but remained significantly higher compared to controls (p = 0.02). ESR and CRP values also fell significantly compared to pretreatment levels (p = 0.0001 in both cases). We observed a significant correlation between the decrease in ESR values and the decrease in sIL-2R and CRP levels after 6 weeks (p = 0.01 in both cases) and after 6 months of therapy (p = 0.002 and p = 0.05). sIL-2R may be considered a useful serologic marker for monitoring response to steroid therapy in patients with PMR/GCA. This laboratory variable correlated more closely with ESR than with CRP. The presence of elevated levels of sIL-2R is likely to reflect T cell activation occurring in PMR/GCA. T lymphocyte activation persisted after 6 months of steroid therapy, despite rapid and continuous control of disease manifestations.