| Effective anti-TNF-alpha therapy can induce rapid resolution and sustained decrease of gastroduodenal mucosal amyloid deposits in reactive amyloidosis associated with rheumatoid arthritis. | |
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MedLine Citation:
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PMID: 19797512 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the effect of anti-tumor necrosis factor-alpha (anti-TNF) therapy in patients with reactive AA amyloidosis associated with rheumatoid arthritis (RA). METHODS: Fourteen patients with reactive AA amyloidosis associated with RA were prospectively evaluated. Four patients were treated with infliximab and 10 with etanercept. The mean period of anti-TNF therapy was 20.1 +/- 13.8 months. Laboratory findings and renal function were examined before and after initiation of anti-TNF therapy. In 9 patients the area of amyloid deposits in serial gastroduodenal mucosal biopsy specimens was examined and image analysis was performed. RESULTS: C-reactive protein and serum amyloid A protein levels were significantly reduced after initiation of anti-TNF therapy. Twenty-four hour creatinine clearance improved in 4 patients, did not change in 5, and deteriorated in 3. Twenty-four hour urinary protein excretion was significantly decreased in 3 patients, not exacerbated in 6, and increased in 3 after initiation of anti-TNF therapy. The biopsy specimens from the 9 patients who underwent serial gastroduodenal biopsies showed significant decreases in the area of amyloid deposits, from 8.8% +/- 6.4% to 1.6% +/- 0.6% (p = 0.003) after initiation of anti-TNF therapy. Four patients showed a sustained decrease in the areas of amyloid deposits in their third biopsy specimens, and amyloid deposits were not detectable in 2. CONCLUSION: Our results indicate a striking effect of anti-TNF therapy for rapid removal and sustained disappearance of amyloid deposits in gastric mucosal tissue with amelioration of renal functions in patients with reactive amyloidosis due to RA. |
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Authors:
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Takeshi Kuroda; Yoko Wada; Daisuke Kobayashi; Shuichi Murakami; Takehito Sakai; Shintaro Hirose; Naohito Tanabe; Takako Saeki; Masaaki Nakano; Ichiei Narita |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-10-01 |
Journal Detail:
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Title: The Journal of rheumatology Volume: 36 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-06 Completed Date: 2010-02-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: Canada |
Other Details:
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Languages: eng Pagination: 2409-15 Citation Subset: IM |
Affiliation:
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Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Cyuo-ku, Niigata, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Amyloid / immunology Amyloidosis* / drug therapy, pathology Anti-Inflammatory Agents / therapeutic use Antibodies, Monoclonal / therapeutic use Arthritis, Rheumatoid* / drug therapy, immunology, pathology Duodenum / anatomy & histology, pathology Female Gastric Mucosa / pathology* Gastrointestinal Agents / therapeutic use Humans Immunoglobulin G / therapeutic use Immunosuppressive Agents / therapeutic use* Intestinal Mucosa / pathology* Male Middle Aged Receptors, Tumor Necrosis Factor / therapeutic use Tumor Necrosis Factor-alpha / antagonists & inhibitors*, immunology Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Amyloid; 0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Gastrointestinal Agents; 0/Immunoglobulin G; 0/Immunosuppressive Agents; 0/Receptors, Tumor Necrosis Factor; 0/Tumor Necrosis Factor-alpha; 0/infliximab; 185243-69-0/TNFR-Fc fusion protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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