依那西普治疗活动性强直性脊柱炎的作用机制研究

Study on Action Mechanism of Etanercept for the Treatment of Active Ankylosing Spondylitis

【目的】研究肿瘤坏死因子a拮抗剂依那西普治疗强直性脊柱炎（AS）的疗效及作用机制。【方法143例活动性AS患者，随机分为治疗组（23例，给予依那西普25mg，皮下注射，2次／周，共6周）和对照组（20例，给予安慰荆治疗）。用流式细胞术分析比较两组治疗前后患者树突状细胞（DC）和调节性T细胞（Treg）水平。酶联免疫吸附试验（ELISA）检测血清中可溶性白细胞介素2（IL-2）受体水平。【结果】治疗组与对照组比较DC和Treg数量升高（P〈0．05），血浆可溶性IL-2受体水平降低（Pd0．05）。【结论】依那西普阻断DC的成熟，从而增强了Treg的水平，并抑制了效应T细胞的功能从而改善病人的临床症状。

[ Objective]To explore the action mechanism of etanercept for the treatment of active ankylosing spondylitis（A$）. EMethods~ Forty-three active AS patients were randomly divided into treatment group and control group. The treatment group（ n =23） received etanercept 25rag by subcutaneous injections twice a week. The control group（ n =20） received placebo therapy. Flow cytometry was used to analyze the levels of dendritic cells（DC） and regulatory T cells（Treg） before and after treatment. Enzyme-linked immunosorbent assay（ELISA） was used to detect serum soluble interleukin-2 （IL-2） receptor. [Results]Compared with the control group, DC and Treg level increased （ P 〈0.05） and soluble IL-2 receptor decreased in the treatment group（ P 〈0.05）. [Conclusion]Etanercept can block the DC maturation, increase the level of regulatory T cell and inhibit the function of responsive T cells so as to improve clinical symptoms of active AS patients.