活动期青少年类风湿关节炎的炎症状态与低高密度脂蛋白血症及脂蛋白相关血小板活化因子乙酰水解酶活性降低的关联。
Association of the inflammatory state in active juvenile rheumatoid arthritis with hypo-high-density lipoproteinemia and reduced lipoprotein-associated platelet-activating factor acetylhydrolase activity.
作者信息
Tselepis A D, Elisaf M, Besis S, Karabina S A, Chapman M J, Siamopoulou A
机构信息
University of Ioannina, Greece.
出版信息
Arthritis Rheum. 1999 Feb;42(2):373-83. doi: 10.1002/1529-0131(199902)42:2<373::AID-ANR21>3.0.CO;2-3.
OBJECTIVE
To investigate the relationship between the quantitative and qualitative abnormalities of apolipoprotein B (Apo B)- and Apo A-I-containing lipoproteins and between lipoprotein-associated platelet-activating factor acetylhydrolase (PAF-AH) activity in patients with juvenile rheumatoid arthritis (JRA) as a function of the inflammatory state.
METHODS
Twenty-six JRA patients and 22 age- and sex-matched control subjects with normal lipid levels participated in the study. Fourteen patients had active disease, and 12 had inactive disease. Plasma lipoproteins were fractionated by gradient ultracentrifugation into 9 subfractions, and their chemical composition and mass were determined. The PAF-AH activity associated with lipoprotein subfractions and the activity in plasma were also measured.
RESULTS
Patients with active JRA had significantly lower plasma total cholesterol and high-density lipoprotein (HDL) cholesterol levels as compared with controls, due to the decrease in the mass of both the HDL2 and HDL3 subfractions. Patients with active JRA also had higher plasma triglyceride levels, mainly due to the higher triglyceride content of the very low-density lipoprotein plus the intermediate-density lipoprotein subfraction. The plasma PAF-AH activity in patients with active JRA was lower than that in controls, mainly due to the decrease in PAF-AH activity associated with the intermediate and dense low-density lipoprotein subclasses. The lipid abnormalities and the reduction in plasma PAF-AH activity were significantly correlated with plasma C-reactive protein levels and were not observed in patients with inactive JRA.
CONCLUSION
This is the first study to show that patients with active JRA exhibit low levels of HDL2 and HDL3 and are deficient in plasma PAF-AH activity. These alterations suggest that active JRA is associated with partial loss of the antiinflammatory activity of plasma Apo B- and Apo A-I-containing lipoproteins.
目的
研究青少年类风湿关节炎（JRA）患者中载脂蛋白B（Apo B）和载脂蛋白A-I（Apo A-I）脂蛋白的定量和定性异常之间的关系，以及脂蛋白相关血小板活化因子乙酰水解酶（PAF-AH）活性与炎症状态的关系。
方法
26例JRA患者和22例年龄及性别匹配、血脂水平正常的对照者参与了本研究。14例患者患有活动性疾病，12例患有非活动性疾病。通过梯度超速离心将血浆脂蛋白分离为9个亚组分，并测定其化学组成和质量。还测量了与脂蛋白亚组分相关的PAF-AH活性以及血浆中的活性。
结果
与对照组相比，活动性JRA患者的血浆总胆固醇和高密度脂蛋白（HDL）胆固醇水平显著降低，这是由于HDL2和HDL3亚组分的质量均下降。活动性JRA患者的血浆甘油三酯水平也较高，主要是由于极低密度脂蛋白加中间密度脂蛋白亚组分的甘油三酯含量较高。活动性JRA患者的血浆PAF-AH活性低于对照组，主要是由于与中间和致密低密度脂蛋白亚类相关的PAF-AH活性降低。脂质异常和血浆PAF-AH活性降低与血浆C反应蛋白水平显著相关，在非活动性JRA患者中未观察到。
结论
这是第一项表明活动性JRA患者HDL2和HDL3水平较低且血浆PAF-AH活性缺乏的研究。这些改变表明活动性JRA与血浆中含Apo B和Apo A-I脂蛋白的抗炎活性部分丧失有关。
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