目的观察高密度脂蛋白(high density lipoprotein,HDL)对氧化型低密度脂蛋白(oxidized low density lipoprotein,oxLDL)刺激下3T3-L1脂肪细胞肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)mRNA表达的影响,并探讨其可能的作用机制...目的观察高密度脂蛋白(high density lipoprotein,HDL)对氧化型低密度脂蛋白(oxidized low density lipoprotein,oxLDL)刺激下3T3-L1脂肪细胞肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)mRNA表达的影响,并探讨其可能的作用机制。方法 3T3-L1脂肪细胞促分化成熟后,oxLDL刺激脂肪细胞,给予不同浓度的HDL(10～100μg/ml),及H-89(10μmol/L)+HDL(100μg/ml)干预,收集细胞,测定脂肪细胞TNF-αmRNA表达水平,IκB蛋白浓度及核因子-κB(NF-κB)活性。结果 OxLDL刺激使3T3-L1脂肪细胞TNF-αmRNA表达及NF-κB活性明显增强。HDL浓度依赖性抑制TNF-αmRNA表达、NF-κB活化和IκB降解。与oxLDL刺激组比较,100μg/ml HDL使TNF-αmRNA表达降低64.5%,NF-κB活性减少49%,并明显增加IκB蛋白水平。HDL的这些抗炎效应能被蛋白激酶A(PKA)抑制剂H-89部分抑制。结论HDL能抑制oxLDL诱导的3T3-L1脂肪细胞TNF-αmRNA表达,PKA-IκB-NF-κB信号通路是其中作用途径之一,该效应不需要HDL与oxLDL的直接接触作用。展开更多
Thiopurine analogs and anti-tumor necrosis factor (TNF) agents have dramatically changed the therapeutics of inflammatory bowel diseases (IBD), improving short and long-term outcomes. Unfortunately some patients do no...Thiopurine analogs and anti-tumor necrosis factor (TNF) agents have dramatically changed the therapeutics of inflammatory bowel diseases (IBD), improving short and long-term outcomes. Unfortunately some patients do not respond to therapy and others lose response over time. The pharmacokinetic properties of these drugs are complex, with high inter-patient variability. Thiopurine analogs are metabolized through a series of pathways, which vary according to the patients’ pharmacogenetic profile. This profile largely determines the ratios of metabolites, which are in turn associated with likelihoods of clinical efficacy and/or toxicity. Understanding these mechanisms allows for manipulation of drug dose, aiming to reduce the development of toxicity while improving the efficacy of treatment. The efficacy of anti-TNF drugs is influenced by many pharmacodynamic variables. Several factors may alter drug clearance, including the concomitant use of immunomodulators (thiopurine analogs and methotrexate), systemic inflammation, the presence of anti-drug antibodies, and body mass. The treatment of IBD has evolved with the understanding of the pharmacologic profiles of immunomodulating and TNF-inhibiting medications, with good evidence for improvement in patient outcomes observed when measuring metabolic pathway indices. The role of routine measurement of metabolite/drug levels and antibodies warrants further prospective studies as we enter the era of personalized IBD care.展开更多
文摘Thiopurine analogs and anti-tumor necrosis factor (TNF) agents have dramatically changed the therapeutics of inflammatory bowel diseases (IBD), improving short and long-term outcomes. Unfortunately some patients do not respond to therapy and others lose response over time. The pharmacokinetic properties of these drugs are complex, with high inter-patient variability. Thiopurine analogs are metabolized through a series of pathways, which vary according to the patients’ pharmacogenetic profile. This profile largely determines the ratios of metabolites, which are in turn associated with likelihoods of clinical efficacy and/or toxicity. Understanding these mechanisms allows for manipulation of drug dose, aiming to reduce the development of toxicity while improving the efficacy of treatment. The efficacy of anti-TNF drugs is influenced by many pharmacodynamic variables. Several factors may alter drug clearance, including the concomitant use of immunomodulators (thiopurine analogs and methotrexate), systemic inflammation, the presence of anti-drug antibodies, and body mass. The treatment of IBD has evolved with the understanding of the pharmacologic profiles of immunomodulating and TNF-inhibiting medications, with good evidence for improvement in patient outcomes observed when measuring metabolic pathway indices. The role of routine measurement of metabolite/drug levels and antibodies warrants further prospective studies as we enter the era of personalized IBD care.
