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初治早期类风湿关节炎患者滑膜、血清及滑液中的白细胞介素-17模式

IL-17 patterns in synovium, serum and synovial fluid from treatment-naïve, early rheumatoid arthritis patients.

作者信息

Roşu Anca, Mărgăritescu Cl, Stepan A, Muşetescu Anca, Ene M

机构信息

Department of Internal Medicine and Rheumatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Rom J Morphol Embryol. 2012;53(1):73-80.

Abstract

BACKGROUND

There are actually becoming controversial data regarding the profiles of interleukin-17 (IL-17) in different pathogenical stages of rheumatoid arthritis (RA).

OBJECTIVES

To assessing the IL-17 patterns in synovium, serum and synovial fluid from treatment-naïve early RA patients and to identifying potential correlations with disease activity markers and with synovial histopathological profile.

MATERIALS AND METHODS

Serum samples from 30 treatment-naïve early RA patients were evaluated for C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP). IL-17A levels were also assessed in serum and synovial fluid (SF). Disease activity score (DAS28) calculation was done for all patients. Control serum and SF samples were obtained from 29 patients with osteoarthritis (OA); control synovium specimens were obtained from eight patients with OA and during surgery for knee tear ligaments. Histopathological (Hp) score, immunohistochemical reactivity for IL-17 were also assessed in synovium of early RA patients and controls. Dependencies between serum and synovial profile of IL-17A and the other parameters were statistically tested.

RESULTS

In early RA patients, strong correlations of serum and SF IL-17A levels were found with ESR, CRP, RF, anti-CCP, Hp score and IL-17 synovial immunoreactivity; a good correlation was noted with DAS28 score. Also, strong correlation was noted between serum and SF IL-17A levels.

CONCLUSIONS

In early stages of untreated RA, simultaneous IL-17 assessment of serum, SF and synovium might be valuable in defining activity and predictive patterns, given that synovium is highly suggestive for an disease aggressivity and might express specific therapeutically targets.

摘要

背景

关于类风湿关节炎(RA)不同致病阶段白细胞介素 - 17(IL - 17)的特征,目前的数据实际上存在争议。

目的

评估初治早期RA患者滑膜、血清和滑液中的IL - 17模式,并确定其与疾病活动标志物以及滑膜组织病理学特征的潜在相关性。

材料与方法

对30例初治早期RA患者的血清样本进行C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP)检测。同时评估血清和滑液(SF)中的IL - 17A水平。对所有患者计算疾病活动评分(DAS28)。对照血清和SF样本来自29例骨关节炎(OA)患者;对照滑膜标本取自8例OA患者以及膝关节韧带撕裂手术患者。对早期RA患者和对照的滑膜进行组织病理学(Hp)评分以及IL - 17免疫组化反应性评估。对IL - 17A的血清和滑膜特征与其他参数之间的相关性进行统计学检验。

结果

在早期RA患者中,血清和SF中IL - 17A水平与ESR、CRP、RF、抗CCP、Hp评分以及IL - 17滑膜免疫反应性显著相关;与DAS28评分相关性良好。此外,血清和SF中IL - 17A水平之间也存在显著相关性。

结论

在未经治疗的RA早期,同时对血清、SF和滑膜进行IL - 17评估可能有助于确定疾病活动和预测模式,因为滑膜对疾病侵袭性具有高度提示作用,并且可能表达特定的治疗靶点。

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