循环 Dickkopf-1 与类风湿关节炎的骨质侵蚀和炎症相关。

Circulating Dickkopf-1 is correlated with bone erosion and inflammation in rheumatoid arthritis.

机构信息

Department of Rheumatology and Immunology, Clinical Immunology Center, Beijing University People's Hospital, 11 Xizhimen South Street, Beijing, China.

出版信息

J Rheumatol. 2011 May;38(5):821-7. doi: 10.3899/jrheum.100089. Epub 2011 Mar 1.

DOI:10.3899/jrheum.100089

PMID:21362762

Abstract

OBJECTIVE

To explore the potential role of Dickkopf-1 (DKK-1) in rheumatoid arthritis (RA) and to evaluate the effect of a tumor necrosis factor-α (TNF-α) inhibitor (infliximab) and an interleukin 1 receptor antagonist (IL-1Ra; anakinra) on DKK-1 secretion in patients with RA.

METHODS

Serum samples were collected from 100 patients with RA, 100 patients with other rheumatic diseases (e.g., osteoarthritis and ankylosing spondylitis), and 40 healthy controls. DKK-1 and osteoprotegerin (OPG) levels in serum were detected by ELISA. Serum C-reactive protein (CRP) levels, erythrocyte sedimentation rates (ESR), rheumatoid factor (RF) titers, and anti-cyclic citrullinated peptide antibody were also measured in patients with RA.

RESULTS

The serum level of DKK-1 was significantly higher in patients with RA than in healthy controls and those with other rheumatic diseases (p < 0.01); the serum DKK-1 level was correlated with levels of CRP (r = 0.488, p = 0.003) and ESR (r = 0.458, p = 2.4 x 10(-4)) and the Sharp score of radiologic change (r = 0.449, p = 0.001) in RA. In contrast to the increasing level of OPG, DKK-1 was significantly decreased in RA patients treated with TNF-α inhibitor (p < 0.01). DKK-1 was significantly decreased in RA patients treated with IL-1Ra (p < 0.01).

CONCLUSION

DKK-1, as an important mediator, was correlated with bone erosion and inflammation in RA. The change of DKK-1 level may serve as a biomarker of disease activity and bone erosion.

摘要

目的

探讨 Dickkopf-1（DKK-1）在类风湿关节炎（RA）中的潜在作用，并评估肿瘤坏死因子-α（TNF-α）抑制剂（英夫利昔单抗）和白细胞介素 1 受体拮抗剂（IL-1Ra；阿那白滞素）对 RA 患者 DKK-1 分泌的影响。

方法

收集 100 例 RA 患者、100 例其他风湿病（如骨关节炎和强直性脊柱炎）患者和 40 名健康对照者的血清样本。采用 ELISA 法检测血清 DKK-1 和骨保护素（OPG）水平。RA 患者还检测了血清 C 反应蛋白（CRP）水平、红细胞沉降率（ESR）、类风湿因子（RF）滴度和抗环瓜氨酸肽抗体。

结果

RA 患者血清 DKK-1 水平明显高于健康对照组和其他风湿病患者（p < 0.01）；血清 DKK-1 水平与 CRP（r = 0.488，p = 0.003）和 ESR（r = 0.458，p = 2.4 x 10(-4)）以及 RA 患者放射学变化 Sharp 评分（r = 0.449，p = 0.001）呈正相关。与 OPG 水平升高相反，TNF-α 抑制剂治疗的 RA 患者 DKK-1 水平明显降低（p < 0.01）。IL-1Ra 治疗的 RA 患者 DKK-1 水平明显降低（p < 0.01）。