胸腺基质淋巴细胞生成素在类风湿关节炎和有关节症状的系统性红斑狼疮患者外周血中的表达及其意义

doi:10.13481/j.1671-587x.20160326

摘要/Abstract

摘要：

目的: 检测类风湿关节炎(RA)患者和有关节症状的系统性红斑狼疮(SLE)患者外周血中胸腺基质淋巴细胞生成素(TSLP)的表达水平,探讨TSLP在RA及SLE病程进展中的可能机制。方法: 选取RA患者40例作为RA组,有关节症状的SLE患者20例作为SLE组,另选健康体检者20人作为正常对照组。采用酶联免疫吸附法(ELISA)检测3组研究对象血清TSLP水平,检测RA患者血常规、C反应蛋白(CRP)水平、红细胞沉降率(ESR)和抗环瓜氨酸肽(CCP)抗体水平,记录及触痛关节数(TJC)、肿胀关节数(SJC)和VAS评分,并计算28个关节的疾病活动评分(DAS28-ESR、DAS28-CRP);统计SLE患者关节炎、新发皮疹和黏膜溃疡等临床症状及血常规、24h尿蛋白等相关指标,计算系统性红斑狼疮疾病活动度指数(SLEDAI)。RA组和SLE组患者相关临床指标、评分与血清TSLP水平的相关性分析采用Pearson检验。结果: RA组患者血清TSLP水平明显高于正常对照组(t=2.73,P<0.05),并与CRP、ESR及抗CCP抗体呈正相关关系(r=0.504,P=0.001;r=0.550,P<0.0001;r=0.895,P<0.0001),与DAS28-ESR、DAS28-CRP评分无相关关系(r=0.213,P=0.187;r=0.170,P=0.293)。抗CCP抗体阳性患者血清TSLP水平高于CCP阴性患者(F＝16.99,P<0.05)。SLE组患者血清TSLP水平与正常对照组比较差异无统计学意义(P>0.05),且SLE组患者血清TSLP水平与SLEDAI无相关关系(r=0.079,P=0.749)。结论: RA患者血清TSLP水平明显升高,TSLP参与RA的发病过程并具有促炎作用;TSLP可能对CCP抗体的产生具有调控影响,血清TSLP水平变化对于判断RA治疗效果有一定参考价值。

关键词: 胸腺基质淋巴细胞生成素, 类风湿关节炎, 系统性红斑狼疮, 抗环瓜氨酸肽抗体

Abstract:

Objective: To detect the levels of serum thymic stromal lymphopoietin(TSLP) in the patients with rheumatoid arthritis(RA) or systemic lupus erythemtosus (SLE) with joint symptoms,and to clarify the possible mechanisms of TSLP in the process of RA and SLE. Methods: A total of 40 patients with RA were chosen as RA group,20 SLE patients with joint symptoms were chosen as SLE group,and 20 healthy people were selected as normal control group.The expression levels of serum TSLP of the subjects in various groups were examined by ELISA method and the clinical activity indexes of RA patients were collected,such as C-reaction protein(CRP),erythrocyte sedimentation rate(ESR),cyclic citrullinated peptide(CCP),tender joints count(TJC),swollen joints count(SJC),visual analogue scale(VAS) and disease activity score(DAS28-ESR,DAS28-CRP);the clinical symptoms of SLE patients were collected,such as arthritis,new rash,ulcer and other symptoms; the clinical activity indexes,such as routine blood,24 h urine protein etc.and systemic lupus erythematosus disease activity index(SLEDAI) were estimated.Pearson test was used to analyze the correlation between the serum TSLP level and the indexes of the patients in RA and SLE groups. Results: The level of serum TSLP in the patients with RA was higher than that in normal control group(t=2.73,P<0.05).The level of serum TSLP in the patients with RA was positive correlated with CRP,ESR and anti-CCP antibodies(r=0.504,P=0.001;r=0.550,P<0.0001;r=0.895,P<0.0001); the level of serum TSLP had no correlation with DAS28-ESR and DAS28-CRP(r=0.213,P=0.187;r=0.170,P=0.293).The level of serum TSLP in the patients with positive anti-CCP antibody was higher than that in the patients with negative anti-CCP antibody(F=16.99,P<0.05).The level of serum TSLP in the patients with SLE had no significant difference compared with normal control group(t=0.673,P>0.05),and it had no correlation with SLEDAI(r=0.079,P=0.749). Conclusion: The serum level of TSLP in the patients with RA is obviously increased and TSLP may participate in the pathogenesis of RA and correlate with disease activity.TSLP may be involved in the regulation of anti-CCP antibodies.The changes of serum TSLP level in the RA patients have a certain reference value in monitoring the therapeutic effects.

Key words: thymic stromal lymphopoietin, rheumatoid arthritis, systemic lupus erythemtosus, anti-cyclic citrullinated peptide antibody

中图分类号:

R593.22

高雅, 王晓非. 胸腺基质淋巴细胞生成素在类风湿关节炎和有关节症状的系统性红斑狼疮患者外周血中的表达及其意义[J]. 吉林大学学报(医学版), 2016, 42(03): 556-560.

GAO Ya, WANG Xiaofei. Expressions of thymic stromal lymphopoietin in serum of patients with rheumatoid arthritis or systemic lupus erythemtosus with joint symptoms and their clinical significances[J]. Journal of Jilin University Medicine Edition, 2016, 42(03): 556-560.

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