Tumor Necrosis Factor-alpha In Patients Research Articles

Clinical efficiency of narrowband–ultraviolet B phototherapy and methotrexate therapy and their effects on serum tumor necrosis factor-alpha in patients with cutaneous lichen planus

Objective This study aimed to assess the clinical efficiency of narrowband–ultraviolet B (NB–UVB) phototherapy and methotrexate (MTX) therapy and their effects on serum tumor necrosis factor-alpha (TNF-α) in patients with cutaneous lichen planus (CLP). Patients and methods The present prospective cohort study was carried out on 60 patients with CLP. The included patients were indiscriminately classified into two treatment groups: group A (30 patients) received NB–UVB phototherapy for three months and group B (30 patients) received MTX therapy for 3 months. All the patients were assessed clinically and TNF-α before and after treatments. Results There were no statistically significant differences between the two groups of treatment with regard to clinical improvement after treatment (P=0.149). Regarding the levels of TNF-α, there was a statistically significant difference between the two treatment groups after treatment (P=0.024). There was a statistically significant reduction in TNF-α level after treatment in the MTX group. Conclusion This study concluded that NB–UVB phototherapy and MTX therapy were clinically effective in the treatment of patients with CLP. MTX therapy was more efficient in the reduction of TNF-α level than NB–UVB phototherapy in patients with CLP.

Effect of modified ShengYangYiwei decoction on painless gastroscopy and gastrointestinal and immune function in gastric cancer patients

Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice. It is of great significance in the clinical diagnosis, treatment, follow-up review and other aspects of gastric cancer patients. The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort. In clinical work, the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose; the application of opioid drugs often causes gastrointestinal reactions, such as nausea, vomiting and delayed gastrointestinal function recovery, after examination. These adverse effects can seriously affect the quality of life of patients. To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function, related complications and immune function in patients with gastric cancer during and after painless gastroscopy. A total of 106 patients with gastric cancer, who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy, were randomly divided into a treatment group (n = 56) and a control group (n = 50). Before the examination, all patients fasted for 8 h, provided their health education, and confirmed if there were contraindications to anesthesia and gastroscopy. During the examination, the patients were placed in the left decubitus position, the patients were given oxygen through a nasal catheter (6 L/min), the welling needle was opened for the venous channel, and a multifunction detector was connected for monitoring electrocardiogram, oxygen saturation, blood pressure, etc. Naporphl and propofol propofol protocols were used for routine anesthesia. Before anesthesia administration, the patients underwent several deep breathing exercises, received intravenous nalbuphine [0.nalbuphine (0.025 mg/kg)], followed by intravenous propofol [1.propofol (1.5 mg/kg)] until the palpebral reflex disappeared, and after no response, gastroscopy was performed. If palpebral reflex disappeared, and after no response, gastroscopy was performed. If any patient developed movement, frowning, or hemodynamic changes during the operation (heart rate changes during the operation (heart rate increased to > 20 beats/min, systolic blood pressure increased to > 20% of the base value), additional propofol [0.propofol (0.5 mg/kg)] was added until the patient was sedated again. The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination, while the patients in the control group received routine gastrointestinal endoscopy. The patients in the two groups were examined by conventional painless gastroscopy, and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared. These characteristics included the total dosage of propofol during the examination, the incidence of complications during the operation, the time of patients' awakening, the time of independent activities, and the gastrointestinal function of the patients after examination, such as the incidence of reactions such as malignant vomiting, abdominal distension and abdominal pain, as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction (T0), after conscious extubation (T1) and 24 h after surgery (T2). There was no difference in the patients' general information, American Society of Anesthesiologist classification or operation time between the two groups before treatment. In terms of painless gastroscopy, the total dosage of propofol in the treatment group was lower than that in the control group (P < 0.05), and the time of awakening and autonomous activity was significantly faster than that in the control group (P < 0.05). During the examination, the incidence of hypoxemia, hypotension and hiccups in the treatment group was significantly lower than that in the control group (P < 0.01). In terms of gastrointestinal function, the incidences of nausea, vomiting, abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group (P < 0.01). In terms of immune function, in both groups, the number of CD4+ and CD8+ cells decreased significantly (P < 0.05), and the number of natural killer cells increased significantly (P < 0.05) at T1 and T2, compared with T0. The number of CD4+ and CD8+ cells in the treatment group at the T1 and T2 time points was higher than that in the control group (P < 0.05), while the number of natural killer cells was lower than that in the control group (P < 0.05). In terms of inflammatory factors, compared with T0, the levels of interleukin (IL) -6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased (P < 0.05). The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group (P < 0.05). The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy, improve the gastrointestinal function of patients after the operation, reduce the occurrence of examination-related complications.

The role of regulatory micro-RNAs in inflammatory processes and production of tumor necrosis factor-alpha in patients with rheumatoid arthritis

Background. Micro-RNAs are fundamental agents of post-transcriptional control of gene expression. In recent years many works have appeared on the possible role of micro-RNAs in rheumatoid arthritis (RA). Studies of the role of micro-RNA and the relationship with the synthesis of tumor necrosis factor-α (TNF-α) are very promising for understanding the pathogenesis and treatment of RA and other autoimmune diseases. The purpose of the research was to study the role of regulatory micro-RNAs in inflammatory processes and the possible connection with the production of TNF-α in patients with RA. Materials and methods. 29 patients with active RA and 20 healthy individuals (control) were examined. All subjects were examined for 16 micro-RNAs. The choice of micro-RNA was based on previous studies and theoretical conclusions (according to the miRWalk database). Rheumatoid factor, the level of antibodies to cyclic peptides containing citrulline, C-reactive protein (СRP), levels of TNF-α (serum, spontaneous, and stimulated) were determined in the blood of patients. Results. Statistical analysis demonstrated significant overexpression of miR-221, miR-203, miR-146b, miR-132, miR-21 and miR-17-3p and inhibition of miR-223 synthesis in RA patients. The activation of TNF-α synthesis at rest and the increased production of TNF-α by mononuclear cells after stimulation in RA were shown. Differences in the levels of relative expression of some micro-RNAs between seropositive and seronegative groups of RA patients were found, but only hyperexpression of miR-155 was highly reliable. For the first time, a possible relationship between TNF-α production and miR-29 and miR-155 micro-RNAs, as well as a correlation between miR-16, miR-99b and miR-203 and CRP levels, was revealed. Conclusions. The obtained data on the profile of micro-RNAs in RA makes it possible to distinguish the most “interesting” micro-RNAs for further study of pathogenesis, their role in inflammation, to study the choice of TNF-α inhibitors, and predicting the effectiveness of that treatment.

A systematic review and meta-analysis of the evidence on inflammation in depressive illness and symptoms in chronic and end-stage kidney disease.

Depression affects approximately 27% of adults with chronic kidney disease (CKD) and end-stage kidney failure (ESKF). Depression in this population is associated with impaired quality of life and increased mortality. The extent of inflammation and the impact on depression in CKD/ESKF is yet to be established. Through a systematic literature review and meta-analysis, we aim to understand the relationship between depression and inflammation in CKD/ESKF patients. We searched nine electronic databases for published studies until January 2022. Titles and abstracts were screened against inclusion and exclusion criteria. Data extraction and study quality assessment was carried out independently by two reviewers. A meta-analysis was carried out where appropriate; otherwise a narrative review of studies was completed. Sixty studies met our inclusion criteria and entered the review (9481 patients included in meta-analysis). Meta-analysis of cross-sectional associations revealed significantly higher levels of pro-inflammatory biomarkers; C-reactive protein; Interleukin 6 (IL-6) and tumour necrosis factor-alpha in patients with depressive symptoms (DS) compared to patients without DS. Significantly lower levels of anti-inflammatory cytokine IL-10 were found in patients with DS compared to patients without DS. Considerable heterogeneity was detected in the analysis for most inflammatory markers. We found evidence for an association of higher levels of pro-inflammatory and lower anti-inflammatory cytokines and DS in patients with CKD/ESKF. Clinical trials are needed to investigate whether anti-inflammatory therapies will be effective in the prevention and treatment of DS in these patients with multiple comorbidities.

Serum Tumor Necrosis Factor-Alpha Levels in Acute Leukemia and Its Prognostic Significance.

IntroductionTumor necrosis factor-alpha (TNF-α) is a pleiotropic cytokine that facilitates malignant cells in immune evasion, survival, and treatment resistance by generating a favorable milieu for them. It is shown to be ectopically produced by malignant/leukemic and immune cells in the tumor microenvironment, providing a tumor-supportive environment and playing an important part in the establishment and progression of malignant cells. It is linked to hyperleukocytosis, high blast count, and poor clinical outcomes in acute leukemia (AL). Considering the varied role and different expression patterns of tumor necrosis factor-alpha in acute leukemia and its clinical relevance, the present study was planned to monitor the level of tumor necrosis factor-alpha in patients with acute leukemia and its correlation with disease outcome. The aim of this study was to monitor the level of tumor necrosis factor-alpha in patients with acute leukemia at the time of diagnosis and after induction chemotherapy.Material and methodsThe study included cases classified as acute leukemia based on morphological examination, bone marrow analysis, and flow cytometry. In all patients with acute leukemia (n = 90) and controls (n = 10), the serum tumor necrosis factor-alpha level was measured using a Diaclone Human ELISA kit (Diaclone, Besancon, France) (solid phase sandwich ELISA) at diagnosis and after induction chemotherapy.ResultsTumor necrosis factor-alpha levels were substantially higher in T-acute lymphoblastic leukemia (T-ALL) cases, followed by acute myeloid leukemia (AML) and B-acute lymphoblastic leukemia (B-ALL), at the time of diagnosis, compared to the control. A significant reduction in serum tumor necrosis factor-alpha level was seen in patients with acute leukemia after induction phase chemotherapy (P < 0.05). Tumor necrosis factor-alpha levels were considerably reduced (P < 0.001) in the majority of acute leukemia cases after the induction phase, while high tumor necrosis factor-alpha levels were positively correlated with incomplete remission status in the remaining cases.ConclusionTumor necrosis factor-alpha is involved in the progression of acute leukemia and its relapse. High levels of tumor necrosis factor-alpha are linked to leukocytosis, high blast counts, and worse survival in patients with acute leukemia. Monitoring of tumor necrosis factor-alpha may be helpful in patients with acute leukemia in view of available antitumor necrosis factor-alpha therapy.

Impact of Red Complex Bacteria and TNF-α Levels on the Diabetic and Renal Status of Chronic Kidney Disease Patients in the Presence and Absence of Periodontitis.

Simple SummaryPeriodontitis, referred to as gum disease, is a serious bacterial infection that damages the surrounding structures of the teeth, including the bones, lastly resulting in tooth loss without prompt treatment. The disease primarily occurs as a result of improper maintenance of the oral cavity, eventually causing gum infections, and teeth that are filled with food, tartar, and bacterial deposits. These harmful bacteria under the influence of various environmental and genetic risk factors may migrate to the blood vessels and reach various other organs, including the kidneys, thereby triggering the infection and resulting in the progression of the systemic diseases. In this study, we focused on identifying the levels of gum-disease-causing bacteria and their byproducts, namely, TNF alpha in patients with or without chronic kidney disease. The study comprised 120 participants categorised into 4 groups on the basis of patients who had gum disease and a kidney disorder. Gum, renal, and diabetic parameters were recorded. The bacteria and their products were assessed and found to be higher in patients having both gum disease and CKD disorder. This study indicates that patients with severe gum disease and poor oral health are at risk of developing kidney problems. Thus, the early prevention of gum ailments might reduce the risk of future kidney diseases.Scientific evidence shows a positive association in the etiopathogenesis of periodontitis and chronic kidney disease (CKD). Various confounding factors, such as obesity, diabetes, and inflammation, also play a significant role in the progression of CKD, which remains unexplored. We hypothesise the role of red complex bacteria with various confounding factors associated with chronic kidney disease. The study comprised a total of 120 participants categorised into 4 groups: the control group (C), periodontitis subjects without CKD (P), periodontally healthy chronic kidney disease subjects (CKD), and subjects having both periodontitis and CKD (P + CKD), with 30 subjects in each group. Demographic variables, and periodontal, renal, and diabetic parameters were recorded. Tumour necrosis factor (TNF)-α levels and those of red complex bacteria such as Prophyromonas gingivalis (P.g), Treponema denticola (T.d), and Tonerella forsythia (T.f) were assessed, and the obtained results were statistically analysed. Among the various demographic variables, age showed a level of significance. Mean PI, GI, CAL, and PPD (the proportion of sites with PPD ≥ 5 mm and CAL ≥ 3 mm) were elevated in the P + CKD group. Diabetic parameters such as fasting blood sugar (FBS) and HbA1c levels were also greater in the P + CKD group. Renal parameters such as eGFR and serum creatinine levels were greater in CKD patients. The estimation of red complex periodontal pathogens such as Pg, Td and Tf levels were significantly greater in the P and P + CKD groups. Pearson correlation analysis revealed significant correlation of red complex bacteria with all variables. Greater levels of P.g, T.d and T.f were found in the P groups, thus indicating their important role in the initiation and progression of inflammation of periodontitis and CKD, with diabetes as one of the confounding factors. The study also confirmed a log-linear relationship between TNF-α levels and red complex bacteria, thereby demonstrating the role of inflammatory biomarkers in periodontal disease progression that could contribute to the development of systemic inflammation such as CKD.

Effect of Acupuncture Combined with Tuina on Cervical Curvature and Serum Inflammatory Cytokine Levels in Patients with Cervical Spondylosis

To study the effects of acupuncture and tuina by stages on cervical curvature, serum interleukin-4, interleukin-8 and tumor necrosis factor-alpha in patients with cervical spondylosis. A total of 94 patients with cervical spondylosis admitted from June 2020 to June 2021 were divided into the control group and the study group through random number table with 47 cases in each group. Patients in the control group were treated with tuina and patients in the study group were treated with acupuncture and tuina by stages. One course of treatment was 21 d and both groups were treated for 2 courses. The clinical effects of the patients in the two groups after treatment were compared, the cervical spine curvature and visual analogue scale scores of patients in the two groups before and after treatment were compared and the serum levels of interleukin-4, interleukin-8 and tumor necrosis factor-alpha before and after treatment were compared. The total clinical effective rate of patients in the study group was 91.48 % (43/47), which was higher than 68.09 % (32/47) of patients in the control group. After treatment, the C value of cervical spine physiological curvature of patients in the two groups was higher than that before treatment and the visual analog scale scores, serum interleukin-4, interleukin-8, tumor necrosis factor-alpha levels decreased. The improvement of patients in the study group was better than that in the control group (all p<0.05). Acupuncture and tuina to treat patients with cervical spondylosis by stages can better improve the curvature of the patient’s cervical spines, reduce pain, inhibit inflammation in the body and improve the therapeutic effect.

Correlation analysis of interleukin-10 indicators and tumor necrosis factor-alpha as clinical indicators of rehabilitation treatment of postmastectomy lymphedema in patients after complex breast cancer treatment

Background. Cellular immunity and cytotoxic agents are involved in the inflammatory process and tumor cell apoptosis resolution.Background. Cellular immunity and cytotoxic agents are involved in the inflammatory process and tumor cell apoptosis resolution. Endothelial cell apoptosis violation, imbalanced cytokines are considered as one of the contributory factors for postmastectomy lymphedema development.&#x0D; Aim. To assess the correlation between the interleukin profile (interleukin-10 and tumor necrosis factor-alpha) and clinical indicators of postmastectomy lymphedema in the rehabilitation treatment course after complex breast cancer treatment&#x0D; Materials and methods. The study involved 50 people aged 4065 years. The main group consisted of 40 females who underwent a rehabilitation treatment course for postmastectomy lymphedema. The control group consisted of 10 females with a verified breast cancer diagnosis who were preparing for surgical treatment. The statistical analysis determined the differences between the mean values of indicators using the Mann-Whitney U-test and the Wilcoxon T-test. Spearmans nonparametric correlation analysis was used to determine the relationship between the studied characteristics. Differences between indicators were considered statistically significant at p 0.05.&#x0D; Results. The indices of the studied interleukins in the control group are significantly higher than that of the main group. Interleukin-10 remained unchanged in the course of restorative treatment, whereas tumor necrosis factor-alpha increased from 43.72 10 pg/l to 118.94 14.74 pg/l. After the course, a statistically significant correlation (p 0.05) was found between the levels of the studied interleukins. A positive trend was observed as a result of rehabilitation treatment of postmastectomy lymphedema: the average excess volume in patients of the main group decreased by 38.5%.&#x0D; Conclusion. Evaluation of interleukin-10 and tumor necrosis factor-alpha in patients with postmastectomy lymphedema allows not only the restorative treatment results assessment and determination of the immune status parameter and damage degree of the vascular endothelium of a particular patient but also prognosis formation of malignant neoplasm development.

High Levels of Tumor Necrosis Factor-Alpha and Interferon-Gamma in Patients with Gingival Recession

Background: Gingival recession considers as a common condition that associated with transposition of the margin of the gingiva in to the position apical to the cemento-enamel junction which consequently result in an exposure of the root . Inflammatory biomarker including interferon-gamma and tumor necrosis factor-alpha associated with a significant role in periodontal tissue destruction . The main goals of current study were to compare the levels of interferon-gamma and tumor necrosis factor-alpha in patients with different degree of gingival recession and control participants.Material and method: Blood samples taken from twenty four male participants and they grouped in to three groups as: group 1(8 control subjects) , group 2 (8 patients with class 1 and 2 gingival recession )and group 3 (8 patients with class 3 and 4 gingival recession). Enzyme-linked Immunosorbent Assay was utilized to evaluate tumor necrosis factor-alpha and interferon-gamma levels.Results : The levels of both biomarkers were greater in group 3 than group 1 and group 2 as well as group 2 had higher levels of these biomarkers than group 1.Conclusion: Interferon-gamma and tumor necrosis factor-alpha could reflect periodontal destruction in patients with gingival recession

High Levels of Tumor Necrosis Factor-Alpha and Interferon- Gamma in Patients with Gingival Recession

Background: Gingival recession considers as a common condition that associated with transposition of the margin of the gingiva in to the position apical to the cemento-enamel junction which consequently result in an exposure of the root . Inflammatory biomarker including interferon-gamma and tumor necrosis factor-alpha associated with a significant role in periodontal tissue destruction . The main goals of current study were to compare the levels of interferon-gamma and tumor necrosis factor-alpha in patients with different degree of gingival recession and control participants.Material and method: Blood samples taken from twenty four male participants and they grouped in to three groups as: group 1(8 control subjects) , group 2 (8 patients with class 1 and 2 gingival recession )and group 3 (8 patients with class 3 and 4 gingival recession). Enzyme-linked Immunosorbent Assay was utilized to evaluate tumor necrosis factor-alpha and interferon-gamma levels.Results : The levels of both biomarkers were greater in group 3 than group 1 and group 2 as well as group 2 had higher levels of these biomarkers than group 1.Conclusion: Interferon-gamma and tumor necrosis factor-alpha could reflect periodontal destruction in patients with gingival recession

Comparative Analysis of 3-Year Persistence With Vedolizumab Compared With Antibodies Against Tumor Necrosis Factor-Alpha in Patients With Inflammatory Bowel Disease in Germany: Retrospective Analysis of a Large Prescription Database.

The goal of the study was to compare persistence with vedolizumab versus adalimumab, golimumab, and infliximab in biologics-naïve patients with inflammatory bowel disease treated in gastroenterological practices and outpatient clinics in Germany. Patients aged 18 or older who had initiated a biological therapy (vedolizumab, infliximab, adalimumab, or golimumab) were included in the present study. Prescriptions between July 2014 and March 2017 of the respective biological drug emerging from gastroenterological practices or outpatient clinics in Germany were retrieved from the longitudinal prescription (LRx) database. Patients treated with vedolizumab were matched with patients treated with infliximab, adalimumab, or golimumab on the basis of age, gender, medication before biologic therapy, and index year. The primary outcome variable of the study was the rate of persistence with vedolizumab compared with antitumor necrosis factor biologics (infliximab, adalimumab, and golimumab) within 3 years of the first prescription in outpatient settings. Kaplan-Meier analysis was performed in 15,984 patients naïve to biologics revealing the statistically lower risk of discontinuation for vedolizumab compared with adalimumab, golimumab, or infliximab. In matched-pairs analyses, within 3 years after the first prescription, 39.5% of 2076 patients were persistent to vedolizumab compared with 33.5% of matched patients persistent to adalimumab (P<0.001). 37.6% of 716 patients were persistent to vedolizumab compared with 24.7% of matched patients persistent to golimumab (P<0.001). 35.7% of 2055 patients were persistent to vedolizumab compared with 30.2% of matched patients persistent to infliximab (P=0.119). Vedolizumab was associated with a significantly lower risk of therapy discontinuation compared with adalimumab [hazard ratio (HR)=0.86; 95% confidence interval (CI), 0.81-0.93] and golimumab (HR=0.60; 95% CI, 0.54-0.67), respectively; the vedolizumab risk of therapy discontinuation was numerically lower than infliximab but statistical significance was not achieved (HR=0.93; 95% CI, 0.85-1.02). In biologics-naïve IBD patients treated in outpatient settings in Germany, matched-pair analyses showed that vedolizumab was associated with significantly improved drug persistence compared with adalimumab or golimumab, whereas numerical improvement was shown in comparison with infliximab.

Circulating Leptin, Adiponectin, and Tumor Necrosis Factor-Alpha in Patients Undergoing Surgery Due to Colorectal Cancer

Background: Adipocytokines have been proposed as factors mediating associations between obesity and inflammation in patients with colorectal cancer (CRC). Thus, the aim of this study was to determine the clinical relationships between blood concentrations of leptin (LEP), adiponectin (ADP), and tumor necrosis factor alpha (TNF-alpha) and the outcomes measured in patients with CRC undergoing surgery. Patients and Methods: History, body composition, and blood concentrations of LEP, ADP, and TNF-alpha were determined in 107 patients undergoing surgery due to CRC. The patients were followed up for 619.72 ± 371.65 days. Results: Compared to patients with stage II CRC, individuals with clinical stage I CRC had significantly lower ADP and higher TNF-alpha blood concentrations. We found significant correlations between the clinical stage of CRC (early vs. localized vs. metastatic) and the following: crude blood ADP concentration (R = 0.25; p = 0.015), ADP-to-TNF-alpha ratio (R = 0.31; p = 0.002), and ADP when indexed to body surface area (R = 0.25; p = 0.008) and to fat mass (R = 0.25; p = 0.016). The risk of death during the long-term follow-up period was independently related to the clinical stage of CRC, impairment of the patient’s functional status, and higher blood carcinoembryonic antigen concentration. In Kaplan-Meier survival analysis, patients with blood LEP concentrations adjusted to a visceral adipose tissue score of ≥0.47 had a significantly better likelihood of surviving than their counterparts. Conclusions: In patients with CRC undergoing surgery, blood ADP and TNF-alpha concentrations were associated with the clinical stage of the cancer, likelihood of radical tumor excision, occurrence of nonsurgical postoperative complications, and long-term survival, which suggests the role of dysregulation in the endocrine function of adipose tissue in response to the neoplasmatic process.

Dynamics of Carotid Intima-Media Thickness, Parameters of Arterial Stiffness and Ambulatory Blood Pressure Monitoring during Therapy with Inhibitor of Tumor Necrosis Factor-Alpha in Patients with Early Psoriatic Arthritis

Background . Patients with psoriatic arthritis (PsA) have increased risk of cardiovascular diseases (CVD). Anti-tumor necrosis factor (TNF) therapy is an effective in PsA but its cardiovascular effects are poorly understood. Aim . To study the changes in carotid intima-media thickness (c-IMT), parameters of arterial stiffness (AS), ambulatory blood pressure monitoring (AMBP) in early PsA (EPsA) patients during the anti-TNF therapy with adalimumab (ADA). Material and methods . Patients with EPsA (n=16; 11 females, 5 males; median age 45.5 years, EPsA duration – 7.7 months) were included into the study. All patients were treated with ADA 40 mg every other week up to 3 months. At baseline and after 3 months of therapy all patients were assessed for conventional cardiovascular risk factors, DAS (Disease Activity Score) and HAQ (Health Assessment Questionnaire) indices, C-reactive protein (CRP), c-IMT, ABPM. At baseline the 4 patients had arterial hypertension, and all patients received effective antihypertensive therapy. All patients were assessed for AS parameters: carotid-femoral pulse wave velocity (PWVcf) and index of wave reflection (rigidity index; RI, %). c-IMT was measured using a high-resolution B-mode ultrasound machine. The results are presented in the form of a median – Me (25; 75 percentiles). Results . By the end of the 3rd month of therapy, a decrease in the activity of early PsA was observed as compared to baseline values: DAS decreased from 4.6 (2.9; 1.9) to 1.6 (1.3; 1.9), p=0,001; HAQ from 0.93 (0.81; 1.31) to 0.25 (0; 0.56), p=0,001; CRP from 27.2 (9.7; 33.7) to 1.8 (0.8; 3.1) mg/l, p=0.001. EPsA remission (DAS&lt;1.6) was achieved in 94% of patients. By the end of therapy c-IMT decreased from 0.8 (0.74; 0.85) to 0.73 (0.58; 0.77) mm, p=0,01; as well as AS parameters: PWVcf from 9.9 (7.7; 17.7) to 9.2 (7.4; 10.6) m/s, p&lt;0.05; RI from 69.5 (58; 74) to 49.5 (44; 64)%, p&lt;0.05. AMBPs parameters didn't change significantly. We found significant (p=0.03) decrease in the frequency of the increase in 24-hour diastolic blood pressure. Conclusions . Anti-TNF treatment with ADA improves arterial wall state by decreasing inflammation. These data confirm the idea that inflammation involves in acceleration of atherosclerosis in EPsA patients.

Serum levels of tumor necrosis factor-alpha in patients with psoriasis before, during and after narrow-band UVB phototherapy.

Narrow-band UVB (NB-UVB) phototherapy is widely used worldwide for moderate and severe psoriasis, which is a chronic autoimmune inflammatory disease characterized by skin infiltrates of Th1-, Th17- and Th22-cells releasing locally pro-inflammatory cytokines. We investigate serum levels of tumor necrosis factor-α (TNF-α) in psoriatic patients before and after NB-UVB phototherapy. Twenty-eight subjects with moderate/severe plaque type psoriasis were enrolled. The severity of skin involvement was rated according to the Psoriasis Area and Severity Index (PASI) score at baseline (T0) and after 4 (T1) and 12 (T2) weeks of NB-UVB treatment. At the same time points, blood samples were taken for evaluation of TNF-α levels. NB-UVB phototherapy was administered twice weekly on non-consecutive days until 12 weeks. The median PASI score significantly decreased from 12.0 at baseline (T0), to 6.9 after 4 weeks (T1, P<0.001) and to 0 after 12 weeks (T2, P<0.001). TNF-a serum levels significantly increased in respect to the baseline after 12 weeks of therapy. NB-UVB phototherapy is highly effective against psoriasis but, as it increases the TNF-α serum level, it seems unlikely that it can decrease the chronic inflammatory state that is thought to be responsible of the systemic co-morbidities of psoriasis.

Is major depression associated with serum levels of tumor necrosis factor-alpha in patients with rheumatoid arthritis?

ObjectiveThis study presents the serum tumor necrosis factor-alpha (TNF-α) levels in rheumatoid arthritis (RA) patients with major depression and without any psychiatric disorder. MethodsThe study sample included 61 patients with a diagnosis of RA. Major depression and other psychiatric disorders were screened with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Blood sample for the determination of serum TNF-α level was obtained before the psychiatric interview. ResultsThe prevalence rates of any depressive disorder and any anxiety disorder were 40.3% (n=25) and 22.6% (n=14), respectively. Fifteen (24.2%) patients had major depression alone, whereas 27 (43.5%) patients were not diagnosed with any psychiatric disorder. We could not determine any significant differences between the patients with major depression alone and patients without any psychiatric diagnosis with regard to the serum levels of TNF-α. ConclusionsThe existence of major depression in RA patients does not seem to be associated with serum levels of TNF-α.

Interleukin-10 and tumour necrosis factor-alpha serum levels in chronic Chagas disease patients.

In Chagas disease, chronically infected individuals may be asymptomatic or may present cardiac or digestive complications, and it is well known that the human immune response is related to different clinical manifestations. Different patterns of cytokine levels have been previously described in different clinical forms of this disease, but contradictory results are reported. Our aim was to evaluate the serum levels of interleukin-10 and tumour necrosis factor-alpha in patients with asymptomatic and cardiac Chagas disease. The serum interleukin-10 levels in patients with cardiomyopathy were higher than those in asymptomatic patients, mainly in those without heart enlargement. Although no significant difference was observed in serum tumour necrosis factor-alpha levels among the patients, we found that cardiac patients also present high levels of this cytokine, largely those with heart dilatation. Therefore, these cytokines play an important role in chronic Chagas disease cardiomyopathy. Follow-up investigations of these and other cytokines in patients with chronic Chagas disease need to be conducted to improve the understanding of the immunopathology of this disease.

AB0666 The Survival of the anti Tumor Necrosis Factor Alpha in Patients with Ankylosing Spondylitis as First Line Treatment in Slovenian Nationwide Registry

BackgroundAnkylosing spondylitis is potentially debilitating rheumatic disease. The introduction of biologics in treatment armamentarium made a radical change in prognosis. Anti tumor necrosis factor alpha (TNF-a) are the only biologics...

Extracellular matrix assessment of infected chronic venous leg ulcers: role of metalloproteinases and inflammatory cytokines

Chronic venous ulcer (CVU) represents a dreaded complication of chronic venous disease (CVD). The onset of infection may further delay the already precarious healing process in such lesions. Some evidences have shown that matrix metalloproteinases (MMPs) are involved and play a central role in both CVUs and infectious diseases. Two groups of patients were enrolled to evaluate the expression of MMPs in infected ulcers and the levels of inflammatory cytokines as well as their prevalence. Group I comprised 63 patients (36 females and 27 males with a median age of 68·7 years) with infected CVUs, and group II (control group) comprised 66 patients (38 females and 28 males with a median age of 61·2 years) with non-infected venous ulcers. MMP evaluation and dosage of inflammatory cytokines in plasma and wound fluid was performed by means of enzyme-linked immunosorbent assay test; protein extraction and immunoblot analysis were performed on biopsied wounds. The first three most common agents involved in CVUs were Staphylococcus aureus (38·09%), Corynebacterium striatum (19·05%) and Pseudomonas aeruginosa (12·7%). In this study, we documented overall higher levels of MMP-1 and MMP-8 in patients with infected ulcers compared to those with uninfected ulcers that showed higher levels of MMP-2 and MMP-9. We also documented higher levels of interleukin (IL)-1, IL-6, IL-8, vascular endothelial growth factor and tumour necrosis factor-alpha in patients with infected ulcers with respect to those with uninfected ulcers, documenting a possible association between infection, MMP activation, cytokine secretions and symptoms. The present results could represent the basis for further studies on drug use that mimic the action of tissue inhibitors of metalloproteinases in order to make infected CVU more manageable.

Tear levels of tumor necrosis factor-alpha in patients with Parkinson's disease

Neuroinflammatory events mediated by the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-α) cause progressive neurodegeneration in dopaminergic neurons, and play an important role in the pathogenesis of Parkinson's disease (PD). The purpose of this study was to determine TNF-α levels in tear samples obtained from patients with PD and to analyze the relationship between TNF-α values and PD characteristics. Eighteen patients with PD and 17 healthy control subjects were included in the study. We examined the patient demographics, modified Hoehn and Yahr Staging Scale (mHY) stages, Unified Parkinson's disease rating scale (UPDRS) II and III scores, Mini Mental State Examination (MMSE) scores, and the predominant symptoms. We measured TNF-α using the multiplex immunobead assay in unstimulated tear samples, and determined the Schirmer's test and blink rate for each subject. Tear TNF-α values were significantly higher in patients with PD (196.9±121.2pg/ml) than in control subjects (110.7±87.2pg/ml; p=0.02). We identified no relationship between tear TNF-α levels and age, sex, age at onset, PD duration, mHY stages, UPDRS II, UPDRS III, or MMSE scores. The higher TNF-α levels observed in the tears of patients with PD suggests neuroinflammation and TNF-α plays a role in the pathogenesis of PD. Tear TNF-α levels, however, were not related to the duration or severity of PD. Tears are a suitable method for measuring TNF-α levels, and can be used as a diagnostic measure to evaluate biomarkers in PD.

FRI0170 Pharmacodynamic biomarkers demonstrate overlapping and distinct biological pathways for lymphotoxin-alpha and tumor necrosis factor-alpha in patients with rheumatoid arthritis

BackgroundLymphotoxin (LT)-α, a member of the TNF superfamily, is required for lymph node development and recruitment of B and T cells into lymph nodes via induction of CXCL13 and CCL19...