Reduction of oxidative stress marker levels by anti-TNF-alpha antibody, infliximab, in patients with rheumatoid arthritis.

OBJECTIVE The aim of this study was to evaluate the effects of anti-TNF-alpha antibody, infliximab, on oxidative stress markers representing DNA damage, lipid peroxidation, and glycoxidation. METHODS Twenty-three RA patients underwent infliximab treatment and were analyzed for 30 weeks. Six patients who experienced side effects and one patient who had a reduced efficacy of infliximab were discontinued the infliximab treatment at 30-54 weeks. Sixteen patients were analyzed for 54 weeks. The levels of serum total, urinary total, and free pentosidine, which is an advanced glycation end-product (AGE), and of urinary 15-Isoprostane F2t and 8-hydroxy-deoxy guanosine (8-OHdG) were determined at baseline and at 14, 30, and 54 weeks after initial treatment with infliximab. RESULTS Serum total, urinary total, and free pentosidine levels were reduced at 54 weeks after initial infliximab treatment. Urinary 15-Isoprostane F2t and 8-OHdG levels were also reduced at 14, 30, and 54 weeks. Urinary 8-OHdG levels in RA patients correlated with CRP and the Disease Activity Score of 28 joints. CONCLUSION In RA patients, infliximab plays an essential role as an anti-oxidative agent against AGE formation, oxidative DNA damage and lipid peroxydation.