Effect And Clinical Significance Of RhCTLA-4Ig And Infliximab On Tartrate-resistant Acid Phosphatase 5b Inrheumatoid Arthritis

Objective : To detect the serum level of tartrate-resistant acid phosphatase 5b(TRACP-5b) in patients with rheumatoid arthritis(RA) before and after rhCTLA-4Ig or Infliximab treatment;to analyze the relevances between TRACP-5b and activity indexes of RA;to evaluate the effect of different medicines on bony erosion in RA and its possible mechanism.Methods: 63 patients were divided into three groups, and they were treated with rhCTLA4-Ig(group one),MTX(group two),Infliximab(group three) respectively. The core indicators of RA activity were evaluated:the patients' pain score, morning stiffness, tender joint and swollen joint counts, Health Assessment questionnaire scores(HAQ), rheumatoid factor (RF) ,erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum calcium(Ca2+), alkaline phosphates(ALP), different X-ray stages,disease activity score(DAS).Contrast the serum levels of TRACP-5b in three groups including before and after treatment and analyze the relevances between TRACP-5b and activity indexes of RA.Results: The levels of TRACP-5b in phaseⅠ,Ⅱ,Ⅲ,Ⅳat X-ray stages elevated by turns, the level in phaseⅣ[(4.29±0.35)U/L] was significantly higher(P<0.05) than phaseⅠ[(2.19±0.87)U/L],Ⅱ[(2.71±1.24)U/L],Ⅲ[(2.99±1.19)U/L]. At week 0,week 12,week 24,the serum TRACP-5b level of group one was (2.75±1.36)U/L,(2.24±1.18)U/L,(2.03±0.94)U/L respectively, until 24 weeks the difference was significant (P<0.05). A significant decrease of serum TRACP-5b level in group one[(2.03±0.94)U/L] compared to group two[(2.71±1.02)U/L] after 24 weeks. At week 0,week 14,the serum TRACP-5b level of group three was (3.42±1.09)U/L,(2.96±1.19)U/L respectively, the difference was significant (P<0.05). The serum TRACP-5b level of RA patients achieved ACR70 after Infliximab treatment declined significantly(P<0.05). The correlations were positive between TRACP-5b and tender joint counts(r=0.280 P=0.030),course of disease(r=0.300 P=0.020).Conclusion: RhCTLA4-Ig and Infliximab can reduce TRACP-5b level of RA patients, inhibit inflammatory bone loss. The serum TRACP-5b level was correlated with tender joint counts and course of disease.TRACP-5b can be used to evaluate the efficacy of biologic agents to treat RA patients.