Spelling P, Bonfá E, Caparbo V F, Pereira R M R
Paediatric Rheumatology Division, Hospital Evangelico de Curitiba, Paraná, Brazil.
Scand J Rheumatol. 2008 Nov-Dec;37(6):439-44. doi: 10.1080/03009740802116224.
To evaluate the importance of receptor activator of nuclear factor kappaB (RANK)/receptor activator of nuclear factor kappaB ligand (RANKL)/osteoprotegerin (OPG) modulation in active polyarticular juvenile idiopathic arthritis (pJIA) patients with and without bone erosions.
Thirty female patients (mean age 11.07+/-3.77 years, range 4-17 years) with active pJIA and 30 healthy gender- and age-matched controls were consecutively selected for this study. All involved articulations were assessed by X-ray and examined for the presence of bone erosions. The serum levels of RANKL and OPG were measured using an enzyme-linked immunosorbent assay (ELISA).
Patients with active pJIA had higher levels of serum RANKL than controls [2.90 (0.1-37.4) vs. 0.25 (0.1-5.7) pg/mL, p = 0.007] and a lower OPG/RANKL ratio [21.25 (1.8-897.6) vs. 347.5 (9-947.8), p = 0.005]. However, levels of OPG were comparable in both groups [55.24 (28.34-89.76) vs. 64.42 (30.68-111.28) pg/mL, p = 0.255]. Higher levels of serum RANKL and a lower OPG/RANKL ratio were also observed in active pJIA patients with bone erosions compared to controls [3.49 (0.1-37.4) vs. 0.25 (0.1-5.7) pg/mL, p = 0.0115 and 14.3 (1.8-897.6) vs. 347.5 (9-947.8), p = 0.016]. However, RANKL levels and OPG/RANKL ratio were similar in pJIA patients without bone erosion and controls [1.75 (0.1-10.9) vs. 0.25 (0.1-5.7) pg/mL, p = 0.055 and 29.2 (3.3-756.8) vs. 347.5 (9-947.8), p = 0.281].
These data suggest that active pJIA with bone erosions is associated with high serum levels of RANKL and a low OPG/RANKL ratio, indicating that these alterations may reflect bone damage in this disease.
评估核因子κB受体激活剂（RANK）/核因子κB配体受体激活剂（RANKL）/骨保护素（OPG）调节在有或无骨侵蚀的活动性多关节型幼年特发性关节炎（pJIA）患者中的重要性。
本研究连续选取了30例活动性pJIA女性患者（平均年龄11.07±3.77岁，范围4 - 17岁）和30例年龄及性别匹配的健康对照。通过X线对所有受累关节进行评估，并检查是否存在骨侵蚀。采用酶联免疫吸附测定（ELISA）法检测血清RANKL和OPG水平。
活动性pJIA患者的血清RANKL水平高于对照组[2.90（0.1 - 37.4）对0.25（0.1 - 5.7）pg/mL，p = 0.007]，OPG/RANKL比值低于对照组[21.25（1.8 - 897.6）对347.5（9 - 947.8），p = 0.005]。然而，两组的OPG水平相当[55.24（28.34 - 89.76）对64.42（30.68 - 111.28）pg/mL，p = 0.255]。与对照组相比，有骨侵蚀的活动性pJIA患者血清RANKL水平更高，OPG/RANKL比值更低[3.49（0.1 - 37.4）对0.25（0.1 - 5.7）pg/mL，p = 0.0115；14.3（1.8 - 897.6）对347.5（9 - 947.8），p = 0.016]。然而，无骨侵蚀的pJIA患者与对照组的RANKL水平及OPG/RANKL比值相似[1.75（0.1 - 10.9）对0.25（0.1 - 5.7）pg/mL，p = 0.055；29.2（3.3 - 756.8）对347.5（9 - 947.8），p = 0.281]。
这些数据表明，伴有骨侵蚀的活动性pJIA与血清RANKL水平升高及OPG/RANKL比值降低有关，提示这些改变可能反映了该疾病中的骨损伤。
