Pavlovic Voja, Dimic Aleksandar, Milenkovic Sasa, Krtinic Dane, Aleksic Ivana
Institute of Physiology, Medical Faculty University of Nis, Nikole Uzunovica 67, 18000 Nis, Serbia; tel.: +381 18 276736; fax: +381 18 4238770.
Institute for Treatment and Rehabilitation "Niska Banja", Niska Banja, Serbia.
Open Med (Wars). 2014 Dec 29;10(1):106-112. doi: 10.1515/med-2015-0019. eCollection 2015.
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation and destruction of joint cartilage and bone. Different cytokines play important role in the processes that cause articular destruction and extra-articular manifestations in RA. The contribution of cytokines representing the Th1 (INF-γ), Th2 (IL-4) and IL-17A to the pathogenesis of early RA and bone mineral density (BMD) loss in still poorly understood. Serum samples of 38 early RA patients were evaluated for erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide antibodies (anti-CCP) and for the tested cytokines (IL-17A, IL-4 and INF-γ). BMD was evaluated by dualenergy X-ray absorptiometry (DXA). Disease activity score (DAS28) calculation was assessed for all patients. Control serum samples were obtained from 34 healthy volunteers. The levels of tested cytokines were significantly higher (IL-17A, p<0.001; INF-γ, P<0.001; IL-4, P<0.01) in patients with early RA, compared to the healthy controls. In early RA patients, strong correlation of serum IL-17A was found with DAS28, ESR and CRP. Also, a significant negative correlation was found between serum INF-γ levels and the DAS28 score. Significantly positive correlation of BMD values and CRP, DAS28 IL-17A were also demonstrated. DXA analysis revealed that the most common site for osteoporosis was the lumbar spine followed by the femoral neck. BMD values significantly correlated with CRP, DAS28 score and IL-17A serum levels. The mean serum IL-17A levels, in patients with early RA, corresponded with disease activity, severity and BMD loss, indicating the potential usefulness of serum IL-17A in defining the disease activity and bone remodeling.
类风湿关节炎（RA）是一种慢性炎症性疾病，其特征为滑膜炎症以及关节软骨和骨质破坏。不同的细胞因子在导致RA关节破坏和关节外表现的过程中发挥着重要作用。目前，代表Th1（INF-γ）、Th2（IL-4）和IL-17A的细胞因子对早期RA发病机制和骨密度（BMD）丢失的影响仍知之甚少。对38例早期RA患者的血清样本进行了红细胞沉降率（ESR）、类风湿因子（RF）、C反应蛋白（CRP）、抗环瓜氨酸肽抗体（抗CCP）以及受试细胞因子（IL-17A、IL-4和INF-γ）的评估。采用双能X线吸收法（DXA）评估骨密度。对所有患者计算疾病活动评分（DAS28）。从34名健康志愿者中获取对照血清样本。与健康对照相比，早期RA患者受试细胞因子水平显著更高（IL-17A，p<0.001；INF-γ，P<0.001；IL-4，P<0.01）。在早期RA患者中，发现血清IL-17A与DAS28、ESR和CRP密切相关。此外，血清INF-γ水平与DAS28评分之间存在显著负相关。还证实了骨密度值与CRP、DAS28、IL-17A之间存在显著正相关。DXA分析显示，骨质疏松最常见的部位是腰椎，其次是股骨颈。骨密度值与CRP、DAS28评分和IL-17A血清水平显著相关。早期RA患者血清IL-17A平均水平与疾病活动度、严重程度和骨密度丢失相关，表明血清IL-17A在定义疾病活动度和骨重塑方面具有潜在用途。
