ABSTRACT
To assess the hypothesis if tocilizumab (TCZ) is effective on disease activity, and also its effect in fatigue and other clinical and psychological disease-related factors in patients with rheumatoid arthritis (RA) treated with TCZ.A 24-week, multicenter, prospective, observational study in patients with moderate to severe RA receiving TCZ after failure or intolerance to disease-modifying antirheumatic drugs or tumor necrosis factor-alpha was conducted.Of the 122 patients included, 85 were evaluable for effectiveness (85% female, 51.9â±â12.5 years, disease duration 8.7â±â7.4 years). Mean change in C-reactive protein level from baseline to week 12 was -11.2â±â4.0 (Pâ<â.001). Mean Disease Activity Index score (DAS28) decreased from 5.5â±â1.0 at baseline to 2.7â±â1.3 (Pâ<â.001) at week 24. Mean change in Functional Assessment of Chronic Illness Therapy score was -5.4â±â11.2 points at week 24. Multiple regression analysis showed that the improvement in DAS28, sleep, and depression explained 56% and 47% of fatigue variance at week 12 and 24, respectively.Tocilizumab is effective in reducing disease activity and results in a clinically significant improvement in fatigue, pain, swollen joint count, morning stiffness, sleepiness, depression, and DAS28; the last 3 were specifically identified as factors explaining fatigue variance with the use of TCZ in RA patients.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Arthritis, Rheumatoid/psychology , Arthritis, Rheumatoid/therapy , Fatigue/psychology , Fatigue/therapy , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/physiopathology , Biomarkers/metabolism , C-Reactive Protein/metabolism , Depression/physiopathology , Depression/therapy , Fatigue/etiology , Fatigue/physiopathology , Female , Humans , Male , Middle Aged , Prospective Studies , Retreatment , Sleep , Treatment Outcome , Tumor Necrosis Factor-alpha/therapeutic useABSTRACT
This study investigated the effect of Chlorella vulgaris (C. vulgaris) on genotoxicity, cytotoxicity, and apoptosis in Caco-2 and HT-29 cells. C. vulgaris significantly induced DNA damage in both cell lines at a concentration of 200 µg dry matter/mL (comet tail intensity CTI: 24.6 ± 4.7% for Caco-2, 16.6 ± 0.9% for HT-29). The application of processing (sonication, ball-milling) did not affect the genotoxicity negatively and lowered the lipid peroxidation in C. vulgaris preparations. C. vulgaris-induced intracellular formation of reactive oxygen species in human cell lines and might be responsible for the genotoxic effect. A solid fraction mainly triggered the observed DNA damage (CTI: 41.5 ± 1.9%), whereas a hydrophilic (CTI: 7.9 ± 1.7%) and lipophilic (CTI: 10.2 ± 2.1%) fraction revealed a significantly lower tail intensity. C. vulgaris significantly induced DNA damage in both cell lines possibly through intracellular formation of reactive oxygen species; however, it was repaired after a 2 h recovery time or was even avoided at lower concentrations. In addition, none of the preparations indicated an adverse effect on cell proliferation or revealed apoptotic activity.
