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首页> 外文期刊>Rheumatology >Low-dose prednisolone in early rheumatoid arthritis inhibits collagen type I degradation by matrix metalloproteinases as assessed by serum 1CTP-A possible mechanism for specific inhibition of radiological destruction
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Low-dose prednisolone in early rheumatoid arthritis inhibits collagen type I degradation by matrix metalloproteinases as assessed by serum 1CTP-A possible mechanism for specific inhibition of radiological destruction

机译：血清类1CTP评估类风湿关节炎低剂量泼尼松龙通过基质金属蛋白酶抑制I型胶原降解-特异性抑制放射性破坏的可能机制

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Objective. To study the effects of low-dose prednisolone on the osteoclast-regulating proteins osteoprotegerin (OPG) and RANK ligand (RANKL) and on markers of bone resorption, 1CTP generated by MMPs and CTX-1 generated by cathepsin K, in patients with early RA in relation to inflammation and joint destruction.Methods. In 225 patients, who at the start of the first DMARD had been randomized to 7.5 mg prednisolone daily for 2 years, the P-group, or no prednisolone, the NoP-group, OPG and RANKL were analysed at 0-24 months and 1CTP and CTX-1 at 0-12 months. Radiographs of hands and feet were assessed at 0, 1 and 2 years using the modified Sharp-van der Heijde score and radiological progression defined as increase in total Sharp score above 5.8. Data were analysed with a mixed linear model and by the GENMOD procedure.Results. In the P-group, RANKL and the ratio OPG/RANKL were stable between baseline and 24 months, whereas in the NoP-group, RANKL increased and the ratio OPG/RANKL decreased. CTX-1 decreased significantly more in the P-group. 1CTP decreased over time in both groups, but more in the P-group, P < 0.001, a difference also present in the subgroups of patients in remission. The decrease in 1CTP was associated with less radiological progression after 2 years and displayed a significant interaction with treatment.Conclusion. Low-dose prednisolone may inhibit progression of joint destruction by interfering with MMP activity, seen as a marked decrease in 1CTP, as well as by impairing osteoclast activation, shown by a stable OPG/RANKL ratio.
机译：目的。研究低剂量泼尼松龙对早期RA患者破骨细胞调节蛋白osteoprotegerin（OPG）和RANK配体（RANKL）以及骨吸收标志物，MMP产生的1CTP和组织蛋白酶K产生的CTX-1的影响与炎症和关节破坏有关的方法。在225名患者中，他们在第一次DMARD开始时已被随机分配至7.5 mg泼尼松龙，为期2年，在0-24个月和1CTP时分析了P组或无泼尼松龙，NoP组，OPG和RANKL。和CTX-1（0-12个月）。使用改良的Sharp-van der Heijde评分在0、1和2年对手和脚的X光片进行评估，影像学进展定义为总Sharp评分高于5.8的增加。使用混合线性模型和GENMOD程序分析数据。在P组中，RANKL和OPG / RANKL之比在基线和24个月之间是稳定的，而在NoP组中，RANKL增加而OPG / RANKL之比下降。 P组中CTX-1的下降幅度更大。两组的1CTP随时间下降，但P组的1CTP下降更多，P <0.001，缓解的患者亚组也存在差异。 1CTP的降低与2年后放射学进展较少相关，并显示出与治疗的显着相互作用。低剂量的泼尼松龙可能通过干扰MMP活性（被视为1CTP明显降低）以及破坏破骨细胞活化（以稳定的OPG / RANKL比值显示）来抑制关节破坏的进展。

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