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Objective To observe the recent clinical efficacy of the sequential therapy hormone in the treatment of active rheumatoid arthritis.Methods In accordance with the principle of digital sheet,160 patients with active rheumatoid arthritis were randomly divided into the observation group and the control group,80 cases in each group.On the basis of methotrexate and leflunomide in both groups,the hormone sequential therapy was given in the observation group,but prednisone was given in the control group.The clinical efficacy of treatment after 1 week and 3 months were compared in two groups.Results In the observation group,the indicators in 7 d after treatment were significantly reduced,compared with untreated(t =19.90,7.63,14.73,7.58,6.84,14.09,all P ＜0.01),In the control group,three indicators of the duration of morning stiffness,joint tenderness index and joint swelling index in 7d after treatment were significantly reduced,compared with untreated (t =13.42,3.34,7.24,all P ＜ 0.01),Compared the indicators in the two groups in 7 d after treatment,there were statistically significant differences (t =13.07,4.92,10.51,5.23,5.74,15.03,all P ＜ 0.01).The indicators in the 3 months after treatment in both groups were signifi cantly decreased,buttherewasnosignificantdifferencebetweenthetwogroups (t =1.80,1.73,1.59,1.22,1.21,1.35,all P ＞ 0.05).The total effective rate was 80% in the observation group; but the rate was 75 % in the control group;there was no statistically significant difference in the two groups(x2 =0.57,P ＞ 0.05).Conclusion The sequential hormone therapy is an effective means for the treatment of active rheumatoid arthritis,by controlled the symptoms of rheumatoid arthritis effectively and alleviated the patient's condition.
RESUMO
Objective To study the expression and the role of interleukin (IL)-23/IL-17 axis in colonic tissue of trinitrobenzene sulphonic acid (TNBS) induced eolitic mice.Methods Mice were divided into four groups:control (n=24),TNBS (n= 24),TNBS 48 hours + mlL-17 antibodies (n=24),TNBS 48 hours + normal rat blood-serum (n= 24).TNBS-induced colitis model was constructed.The mice in control group and TNBS colitis group were sacrificed at 24 hours,48 hours,7th day,respectively.In TNBS 48 hours + mlL-17 antibodies group and TNBS 48 hours + normal rat blood-serum group,a single injection with the polyclonal mlL-17 antibodies or serum were given intraperitoneally at two hours before enema with TNBS,respectively,and the mice were killed at 48 hours after enema with TNBS.The histological score of colon and myeloperoxidase (MPO) activity of colonic tissue were evaluated in each group.IL-23p19 and IL-17 concentrations in colonic tissue were measured by enzyme-linked immunosorbent assay (ELISA).Expression of nuclear factor (NF)-κBp65in colonic tissue was detected by immunohistochemistry method.Expression of IL-23p19,IL-17 and IL-12p35 mRNA in colonic tissue were detected by real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-PCR) with SYBR Green I.Results The protein levels of IL-23p19 in colonic tissue in TNBS colitis groups at 24 hours,48 hours and 7 days were (15.53±3.32),(31.16±4.98) and (14.03±3.56) ng/mg,respectively,and their mRNA level were (4.09±0.34),(3.39±0.46) and (6.54±1.82),respectively.The protein levels of IL-17 were (0.35±0.06),(0.38±0.08),and (0.26±0.05) ng/mg,respectively,and their mRNA level were (4.21±2.61),(2.65±0.91) and (5.63±1.43),respectively.The expression levels of IL-23p19 and IL-17 in colitis model were significantly higher than those in control group and the peak was at 48 hours.Moreover,expression of IL-23p19 and IL-17 and their mRNA were positively correlated to their mRNA levels.In TNBS 48 hours + mIL-17 antibodies group,the expression levels of NF-κBp65,the microscopic scores and MPO (1.86 % ± 0.36 %,0.63 ± 0.52,0.40 ± 0.03 U/g,respectively) were significantly lower than those in TNBS 48 hours group (4.35% ±0.37%,5.13±0.64,2.29±0.40 U/g tissue,respectively).Neutralization of IL-17 was significantly protected against TNBS-induced colonic inflammation and MPO and expression of NF-κB p65.The results indicated that neutralization of IL-17 significantly reduced colonic inflammation and suppressed NF-κBp65 activation.This protection occurred in the presence of equivalent induction of local IL-23 p19 and high levels of IL-12p35 in the polyclonal raiL-17 antibodies-treated mice.Conclusions IL-23/IL-17 axis plays a critical role at the early acute phase of TNBS-induced inflammation.IL-17 may represent a new target for therapeutic intervention for inflammatory bowel disease.
