注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗类风湿关节炎疗效及与尿沉渣中miR146a表达的相关性

Efficacy of Recombinant Human Tumor Necrosis Factor-α Receptor Ⅱ: Fc in the Treatment of Rheumatoid Arthritis and Its Correlation with miR146a Expression in Urinary Sediment

目的:探讨类风湿关节炎(RA)患者尿沉渣中miR146a的表达与注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(rh TNFR:Fc)治疗RA疗效的相关性。方法:117例中国RA患者接受为期3个月的rh TNFR:Fc的治疗,治疗后评价疗效。治疗前对入选患者尿沉渣中miR146a的表达水平进行检测,分析尿沉渣中miR146a的表达水平与rh TNFR:Fc治疗RA疗效的相关性。结果:117例患者中,达到RA临床缓解新标准的91例患者,其尿沉渣中miR146a的表达水平为(0.39±0.26),显著低于未达标的26例患者的(0.89±0.31),差异有统计学意义(P<0.05)。结论:在治疗前尿沉渣中miR146a的表达水平与rh TNFR:Fc治疗RA的疗效可能相关,具有较低的miR146a表达水平的RA患者对rh TNFR:Fc的疗效反应较好,有可能作为rh TNFR:Fc对RA的疗效预测指标,其具体机制尚需进一步的研究。

Objective： To explore the correlation between the miR146 a expression in urinary sediment of patients with rheumatoid arthritis（ RA） and the efficacy of recombinant human tumor necrosis factor-α receptor Ⅱ： Fc（ rh TNFR： Fc） in the treatment of RA.Methods： Totally 117 patients with RA received 3-month therapy of rh TNFR： Fc were enrolled in the study. Quantitative real-time RTpolymerase chain reaction（ RT-PCR） was performed to determine the expression level of miR146 a in urinary sediment of RA patients.The association of the miR146 a expression and the efficacy of rh TNFR： Fc to RA was analyzed. Results： The expression level of miR146 a in urinary sediment of 91 RA patients with remission（ 0. 39 ± 0. 26） was significantly lower than that of 26 RA patients without remission（ 0. 89 ± 0. 31,P〈0. 05）. Conclusion： The expression level of miR146 a in urinary sediment is significantly lower in RA patients with remission,indicating that urinary miR146 a maybe predict the efficacy of rh TNFR： Fc to RA.