ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of humanized anti-IL-6 receptor monoclonal antibody (tocilizumab) in treatment of systemic juvenile idiopathic arthritis (sJIA).</p><p><b>METHODS</b>Thirteen sJIA patients admitted between December 2015 and November 2016 and received tocilizumab treatment were enrolled in the study. The complete blood count (CBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6) and ferritin levels were measured; American College of Rheumatology Pediatric(ACR Pedi)30/50/70/90 scores were assessed; and the use of glucocorticosteroid and adverse events were documented.</p><p><b>RESULTS</b>Compared with the baseline levels, the CRP and ESR at d3 were decreased (all<0.05); hemoglobin was increased and platelet was decreased at week 2 (all<0.05), ferritin decreased at week 4, white blood cell (WBC) decreased at week 8 after treatment with tocilizumab (all<0.05). The level of IL-6 was rising at d3 and week 2 and descending at week 4, but no significant difference was observed compared with the baseline level (all>0.05). All 13 patients achieved ACR Pedi 30 remission at week 4, 61.5% achieved ACR Pedi 90 remission and glucocorticosteroids were withdrawn at week 20. Twenty two adverse events occurred, and infection accounted for 54.5% (12/22); no severe adverse reactions were observed during 20-week follow-up.</p><p><b>CONCLUSIONS</b>Tocilizumab is safe and effective in treatment of sJIA, with decreasing inflammation, improving disease activity and reducing glucocorticosteroid use.</p>
ABSTRACT
BACKGROUND:With unique structure and physicochemical property, carbon nanotubes have promising application prospects in the fields of drug delivery, biosensor and biomaterials. However, carbon nanotubes are highly hydrophobic and trend to aggregate, and thus carbon nanotubes are hard to be dispersed in solution. Furthermore, carbon nanotubes induce blood coagulation and have cytotoxicity, which greatly limit the application of carbon nanotubes. OBJECTIVE:To prepare heparinized single-wal ed carbon nanotubes and to study the effects of heparin-immobilization on the water solubility, stability as wel as biocompatibility of carbon nanotubes. METHODS:By the method of covalent grafting, heparinized single-wal ed carbon nanotubes was fabricated and characterized by Fourier transform infrared spectroscopy and carbazole assay. Transmission electron microscopy was used to investigate the dispersing performance and suspension stability of heparinized single-wal ed carbon nanotubes in aqueous solution. Anti-Xa activity and activated partial thromboplastin time assays were used to measure the anticoagulation activity of heparinized single-wal ed carbon nanotubes. MTT assay was used to evaluate the cytocompatibility of heparinized single-wal ed carbon nanotubes. RESULTS AND CONCLUSION:Heparin was covalently linked to the surface of single-wal ed carbon nanotubes successful y. The amount of heparin on single-wal ed carbon nanotubes was measured to be 257.53 mg/g. Heparinized single-wal ed carbon nanotubes were wel dispersed and stable in an aqueous solution without aggregation. The anti-Xa activity of heparinized single-wal ed carbon nanotubes was measured to be 36.53 U/mg, suggesting a significant anticoagulant activity. Further study of activated partial thromboplastin time assay found that the anticoagulant effect of heparinized single-wal ed carbon nanotubes could be prolonged. MTT assay revealed that heparinized single-wal ed carbon nanotubes had no cytotoxicity and showed good cytocompatibility. Taken together, the immobilization of heparin on single-wal ed carbon nanotubes wil not only improve its solubility and stability in water, but also endow it with excellent biocompatibility.