title: Suboptimal clinical response to anti-tumor necrosis factor alpha (TNFalpha) antibody therapy in a patient with severe rheumatoid arthritis and lymphadenopathy.
abstract: This concerns a patient with severe rheumatoid arthritis (RA) and lymphadenopathy (LA) who showed suboptimal clinical response to antitumor necrosis factor alpha (TNFalpha) antibody (Ab), cA2 therapy. The assessment of TNFalpha and IL-6 mRNA expression in the swollen lymph-node (LN) of the patient by reverse transcription, polymerase chain reaction (RT-PCR) before cA2 treatment, showed only enhanced IL-6 production, but not TNFalpha. Moreover, cA2 failed to inhibit in-vitro spontaneous IL-6 production in the LN block culture from the patient. Taken together, these results indicate that IL-6 production in the swollen LNs of the patient might not depend on TNFalpha. This might partly cause suboptimal clinical response to anti-TNFalpha Ab therapy in the patient.
authors.affiliation: Department of Medicine III, Osaka University Medical School, Suita City, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Saeki
authors.forename: S
authors.initials: S
authors.lastname: Ohshima
authors.forename: T
authors.initials: T
authors.lastname: Mima
authors.forename: M
authors.initials: M
authors.lastname: Sasai
authors.forename: K
authors.initials: K
authors.lastname: Nishioka
authors.forename: M
authors.initials: M
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Suemura
authors.forename: R
authors.initials: R
authors.lastname: McCloskey
authors.forename: T
authors.initials: T
authors.lastname: Kishimoto
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D000069285:Infliximab; D015850:Interleukin-6 / Q000378:metabolism; D008198:Lymph Nodes / Q000378:metabolism; D008206:Lymphatic Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology* / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab