南方医科大学学报2019，Vol.39Issue(2)：127-133,7.DOI:10.12122/j.issn.1673-4254.2019.02.01
二甲双胍治疗白塞病的临床疗效、安全性和调节Treg/Th17平衡的作用:30例前瞻性研究
Efficacy and safety of metformin for Behcet's disease and its effect on Treg/Th17 balance:a single-blinded, before-after study
摘要
Abstract
Objective Behcet's disease (BD) is an autoimmune disorder that causes most commonly mouth and genital ulcerations and erythema nodules of the skin and currently has limited options of therapeutic medicines.Metformin is recently reported to suppress immune reaction, and we hypothesized that metformin could be an option for treatment of BD.Methods Thirty patients with BD were enrolled in this perspective single-blinded, before-after study.We recorded the changes in the mucocutaneous activity index for BD (MAIBD), relapse frequency, C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) after metformin treatment to assess the changes in the disease activity.We also analyzed the changes in the protein and mRNA expression levels of Foxp3, interleukin-35 (IL-35), transforming growth factor-β (TGF-β), Ror-γt, IL-17, and tumor necrosis factor-α (TNF-α) in these patients using ELISA and qRT-PCR.Results Of the 30 patients enrolled, 26 completed the trial.After the treatment, favorable responses were achieved in 88.46％ (23/26) of the patients, and partial remission was obtained in 11.54％ (4/26) of them.During the treatment, 8 patients complained of gastrointestinal side effects, for which 4 chose to withdraw from the study in the first week.Our results showed that metformin treatment decreased MAIBD and relapse frequency in the patients, and significantly lowered the clinical inflammatory indexes including CRP and ESR.The results of ELISA and qRT-PCR revealed that metformin treatment obviously increased Foxp3 and TGF-β expressions at both the protein and mRNA levels and significantly decreased the levels of ROR-γt, IL-17 and TNF-α as well as IL-35 level in these patients.Conclusion Metformin treatment relieves the clinical symptoms, reduces the inflammatory reaction indexes and regulates the Treg/Th17 axis in patients with BD, suggesting the potential of metformin as a candidate medicine for treatment of BD.关键词
二甲双胍/自身免疫/白塞病/临床效果/调节性T细胞/Th17细胞Key words
metformin/autoimmunity/Behcet&apos/s disease/clinical effeteness/regulatory T cells/Th17 cells引用本文复制引用
陈永,罗丹,林晨红,申艳,蔡剑飞,管剑龙..二甲双胍治疗白塞病的临床疗效、安全性和调节Treg/Th17平衡的作用:30例前瞻性研究[J].南方医科大学学报,2019,39(2):127-133,7.基金项目
Supported by National Natural Science Foundation of China (81871276) （81871276）
Clinical Science Innovation Program of Shenkang Hospital Development Center (SHDC12017129) （SHDC12017129）
