ABSTRACT
Objective To explore the effect of anti-TNF rcMAb in the treatment of patients with rheumatoid arthritis (RA) and its effect on peripheral blood Th1,Th17 and Treg cells.Methods Fifty rigorously screened RA patients were randomly divided to the therapy group (n=40) who received the combined treatment of anti-TNF rcMAb and MTX,and control group (n=10) who were given MTX along with placebo,both at week 0,2,6,and 14.The clinical data of the two groups were observed and accessed respectively at week 0 and 18.In addition,the percentage of Th1,Th17,Treg cells in the peripheral blood and the relative gene expressions of transcription factors T-bet,RORC,Foxp3 in these patients were also observed respectively before and after treatment.We used t inspection and x2 inspection as the statistical analysis methods in conducting this study.Results Comparing with the control group,more patients achieved ACR20,ACR50 and ACR70 response in the combined therapy group (Z=1.671,P=0.000 94).The percentage of peripheral blood Th1 cells decreased [week 0:(7.1±3.9)％; week 18:(4.2±2.8)％] and the percentage of Treg cells obviously increased [week 0:(1.5±0.8)％; week 18:(3.0±0.6)％,t=2.301,P=0.048] in the combined therapy recipients,while the percentage of Th1 cells fell [week 0:(9.1±3.1)％; week 18:(5.8±2.6)％] and that of Treg cells slightly increased [week 0:(1.2±0.6)％; week 18:(2.2±0.6)％] in the controls.The mRNA expressions of RORC and T-bet,the transcription factors of Th17 and Th1,were decreased respectively and that of Foxp3,the transcription factor of Treg,were elevated in both groups.Conclusion The combined therapy of anti-TNF rcMAb and MTX is very effective in RA patients.Good outcome is likely achieved by modifying the peripheral blood Th cell subsets in patients with RA.