Abstract | OBJECTIVE: METHODS: RESULTS: At 16 weeks, the cyclosporine group (n = 17), compared with the placebo group (n = 17), had greater decreases in tender joints, swollen joints, patient global assessment, patient self-assessed disability, and C-reactive protein, as well as having more patients with > 20% improvement. Comparison of circulating cytokines at entry and at 16 weeks showed significant decreases of IL-2 (median -61 vs 7 pg/ml; p = 0.004) ("+" denotes increase, "-" denotes decrease), IL-12 (median -313 vs -14 pg/ml; p = 0.002), TNF-alpha (median -55 vs 5 pg/ml; p < 0.001), and IFN-gamma (median -21 vs 5 pg/ml; p = 0.003), and a significant increase of IL-10 (median 55 vs -12 pg/ml; p < 0.001) in the cyclosporine group compared with the placebo group. The degree of IL-10 increases correlated strongly with the degree of IL-12 decreases in the cyclosporine group (r = 0.572, p = 0.016). However, there was no change in circulating IL-4 between the 2 groups. Within the cyclosporine group, the improved patients (n = 10) compared to the non-improved patients (n = 7) had a greater increase in circulating IL-10 (median 172.0 vs 85.2%; p = 0.01). The rate of increase of IL-10 strongly correlated with the rate of improvement of joint scores (r = 0.718, p = 0.001) after administration of cyclosporine. CONCLUSION: Our results suggest that the therapeutic effect of cyclosporine is achieved by correcting a Th1/Th2 imbalance (a shift of Th1 type to Th2 type), which may be involved in the pathogenesis of RA; and that circulating IL-10 is useful to assess the clinical improvements in patients with RA after administration of cyclosporine.
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Authors | W U Kim, M L Cho, S I Kim, W H Yoo, S S Lee, Y S Joo, J K Min, Y S Hong, S H Lee, S H Park, C S Cho, H Y Kim |
Journal | The Journal of rheumatology
(J Rheumatol)
Vol. 27
Issue 2
Pg. 324-31
(Feb 2000)
ISSN: 0315-162X [Print] Canada |
PMID | 10685792
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Cytokines
- Immunosuppressive Agents
- Cyclosporine
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Topics |
- Adult
- Arthritis, Rheumatoid
(blood, drug therapy, immunology)
- Cyclosporine
(administration & dosage)
- Cytokines
(blood, immunology)
- Double-Blind Method
- Female
- Humans
- Immunosuppressive Agents
(administration & dosage)
- Male
- Middle Aged
- Th1 Cells
(immunology)
- Th2 Cells
(immunology)
- Treatment Outcome
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