Li Min, Wu Xiao-hui, Yin Geng, Xie Qi-bing
Sichuan Da Xue Xue Bao Yi Xue Ban. 2015 Mar;46(2):276-9.
To investigate the correlation of the receptor activator of nuclear factor kappa-B ligand (RANKL)/serum osteoprotegerin (OPG) system, Dickkopf-1 (DKK-1) and bone marrow edema (BME) in rheumatoid arthritis (RA) with the complaint of knee pain.
The clinical data of 50 cases of RA with the complaint of knee pain were collected. According to MRI finding, half of them (25 cases) had bone marrow edema (BME). Each patient received the measurement of serum OPG, RANKL, DKK-1, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti cyclic citrullinated peptide antibody (CCP), rheumatoid factort(RF). The clinical symptoms, disease activity score 28 (DAS28), were compared between BME and non-BME griups, and the correlation between RANKL/OPG system, DKK-1 and BME of RA was analyzed.
Compared with non BME group, BME group had shorter course (P=0.000), higher DAS28 score (P=0.009), CRP (P=0:000), RF (P=0.033) and CCP (P=0.012). lower level of serum OPG (P=0.000), higher level of RANKL (P=0.000), RANKL/OPG (P=0.000), and DKK-1 (P=0.001). The severity of bone marrow edema was correlated with the serum RANKL (volume r(s)=0.31, P=0.027; degree r(s)=0.33, P=0.022), RANKL/OPG (volume r(s)=0.29, P=0.039; degree r(s)=0.28, P=0.043), DKK-1 (volume r(s)=0.33, P=0.021; degree r(s)=0.34, P=0.019).
BME is one of the early signs of bone erosion in RA, there were more active inflammation, autoantibodies, and osteocasts in RA patients with BME.
探讨类风湿关节炎（RA）患者中核因子κB受体活化因子配体（RANKL）/血清骨保护素（OPG）系统、Dickkopf-1（DKK-1）与膝关节疼痛主诉的骨髓水肿（BME）之间的相关性。
收集50例有膝关节疼痛主诉的RA患者的临床资料。根据MRI检查结果，其中一半（25例）有骨髓水肿（BME）。每位患者均接受血清OPG、RANKL、DKK-1、C反应蛋白（CRP）、红细胞沉降率（ESR）、抗环瓜氨酸肽抗体（CCP）、类风湿因子（RF）的检测。比较BME组和非BME组的临床症状、疾病活动度评分28（DAS28），并分析RA患者RANKL/OPG系统、DKK-1与BME之间的相关性。
与非BME组相比，BME组病程较短（P=0.000），DAS28评分较高（P=0.009），CRP（P=0.000）、RF（P=0.033）和CCP（P=0.012）水平较高，血清OPG水平较低（P=0.000），RANKL（P=0.000）、RANKL/OPG（P=0.000）和DKK-1（P=0.001）水平较高。骨髓水肿的严重程度与血清RANKL（体积r(s)=0.31，P=0.027；程度r(s)=0.33，P=0.022）、RANKL/OPG（体积r(s)=0.29，P=0.039；程度r(s)=0.28，P=0.043）、DKK-1（体积r(s)=0.33，P=0.021；程度r(s)=0.34，P=0.019）相关。
BME是RA骨侵蚀的早期征象之一，有BME的RA患者存在更活跃的炎症、自身抗体和破骨细胞。
