阿仑膦酸钠维D3或维生素D2预处理对首次静脉输注唑来膦酸炎症细胞因子及外周血T淋巴细胞的影响OA北大核心CSTPCD

Objective To investigate the effects of pretreatment with alendronate sodium with vitamin D3 or a single intramuscular injection of vitamin D2 on peripheral blood inflammatory cytokines and T lymphocyte subsets in post-menopausal women with osteoporosis who received the first infusion of zoledronic acid.Methods A total of 97 postmeno-pausal women with osteoporosis were randomly divided into three groups as alendronate sodium with vitamin D3 group(n=33),vitamin D2 group(n=31),and control group(n=33)by a random number table.Peripheral blood was col-lected before and 24 hours after the first infusion of zoledronic acid.The clinical data,peripheral blood inflammatory cyto-kines and T lymphocyte surface markers before and after infusion of zoledronic acid were compared and analyzed among the three groups.Results There were no statistically significant differences in inflammatory cytokines like interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)and peripheral blood T lymphocyte surface markers like CD3+and CD3+/CD3+CD69+among the three groups before intravenous infusion of zoledronic acid(all P＞0 05).IL-6,TNF-α and INF-γ were significantly higher after infusion of zoledronic acid than baseline in all the three groups(all P＜0.05).The increase of IL-6 was significantly higher in the control group than in the other two groups(P＜0.05),and was higher in the vitamin D2 group than in the alendronate sodium with vitamin D3 group(P=0.002).There were no sig-nificant differences in the increase of TNF-α and INF-γ after infusion of zoledronic acid among the three groups.CD3+T lymphocytes decreased in all groups after the infusion,with the alendronate sodium with vitamin D3 group showing a lesser reduction than the control group(P=0.040).The proportion of CD3+/CD3+CD69+T lymphocytes increased in all groups after the infusion,with a more significant increase in the control and vitamin D2 groups compared to the alendronate sodium with vitamin D3 group(P=0.047,P=0.046).There were no significant differences in the changes of CD3+/CD3+TCRγδ+,CD3+/CD3+TCRγδ+/CD27-IL-23R+,CD3+/CD3+TCRγδ+/CD27-IL-23R-,CD3+/CD3+TCRγδ+/CD27dim IL-23R-,and CD3+/CD3+TCRγδ+/CD27High IL-23R-levels before and after the infusion among the three groups.Conclusion Pretreatment with alendronate sodium with vitamin D3 or vitamin D2 can reduce IL-6 production associated with the acute-phase response induced by the first intravenous infusion of zoledronic acid.Pretreatment with alendronate so-dium with vitamin D3 preserves the number of CD3+T lymphocytes,decreases the production of CD3+/CD3+CD69+T lym-phocytes,reduces the activation of inflammatory related lymphocytes,and alleviates the acute-phase response during the first infusion of zoledronic acid.