Anti-tumour necrosis factor 
therapy modulates ghrelin in patients with severe rheumatoid arthritis
1 Division of Rheumatology, Hospital Xeral Calde, Lugo, Spain
2 Division of Cardiology, Hospital Xeral Calde, Lugo, Spain
3 Division of Endocrinology, Hospital Xeral Calde, Lugo, Spain
4 Endocrinology Research Unit, Hospital Universitario Valdecilla, Santander, Spain
5 Consejo Superior de Investigaciones Cientificas, Granada, Spain
6 The Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand and Rheumatology Unit, Milpark Hospital, Johannesburg, South Africa
7 Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander and CIBER Epidemiología y Salud Pública (CIBERESP), Spain
Correspondence to:
Miguel A Gonzalez-Gay, Rheumatology Division, Hospital Xeral-Calde, c) Dr Ochoa s/n, 27004, Lugo, Spain; miguelaggay@hotmail.com
Accepted 8 February 2008
| The first 150 words of the full text of this article appear below. |
The mechanisms involved in inflammation related accelerated atherosclerosis and cardiovascular disease in rheumatoid arthritis (RA) require further study.1
Ghrelin, the endogenous ligand for the growth hormone secretagogue receptor, a gastric peptide playing a role in the appetite regulation, possesses anti-inflammatory properties.2 Otero et al showed reduced ghrelin plasma concentrations in patients with RA compared to controls.3
Improvement of insulin resistance in patients with severe disease who started anti-tumour necrosis factor (TNF)
therapy has been described previously.4 Additionally, we have reported a rapid improvement in endothelial dysfunction5 and insulin sensitivity6 following the infusion of the chimeric anti-TNF/monoclonal antibody/infliximab in patients with RA with severe disease on periodical treatment with this drug. Moreover, inhibition of basal and TNF-induced cytokine release following intravenous administration of ghrelin has been observed.7
To assess whether infliximab administration alters circulating concentrations of ghrelin, we studied 33 consecutive non-diabetic patients with RA on periodical treatment with
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