Department of Integrated Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).
Med Sci Monit. 2018 May 25;24:3472-3478. doi: 10.12659/MSM.907540.
BACKGROUND The aim of this study was to explore the possible correlations of serum interleukins and soluble ST2 (sST2) protein with clinical features and inflammatory cytokines in rheumatoid arthritis (RA) patients, as well as to assess ability of TCM (Traditional Chinese Medicine) syndromes to differentiate RA patients and evaluate prognosis. MATERIAL AND METHODS Thirty RA patients and 25 healthy individuals were enrolled. Syndrome activity was evaluated, and lab tests were performed. Serum levels of IL-10, IL-17, IL-33, and sST2 were assessed by ELISA. RESULTS Serum levels of sST2, IL-33, and pro-inflammation cytokine IL-17 were all up-regulated, while the immunosuppressive cytokine IL-10 was decreased in RA patients. Serum IL-33 level was positively associated with ESR, CRP, and RF, as well as with HAQ score, VAS score, and DAS28 scores (P<0.05). Serum sST2 level was correlated with the morning stiffness time and ESR, as well as scores of HAQ and DAS28 (P<0.05). In addition, IL-33 level was positively corelated with IL-17 (r=0.83, P<0.01) and the relative ratio of IL-10/IL-17 (r=0.904, P<0.01), and was negatively related with IL-10 (r=-0.632, P<0.01). TCM syndrome differentiation was conducted for RA patients, including the hot syndromes and cold syndromes groups. Hot syndromes RA patients had significantly more severe inflammation compared with cold syndromes patients. CONCLUSIONS IL-33 is a possible index for monitoring disease activity and inflammation condition in RA. IL-33 contributes to RA pathogenesis through unbalancing IL-10 and IL-17. In terms of TCM, hot syndromes RA presented more serious inflammation and more active disease activity, indicating a poorer prognosis.
本研究旨在探讨血清白细胞介素（IL）和可溶性 ST2（sST2）蛋白与类风湿关节炎（RA）患者临床特征和炎症细胞因子的可能相关性，以及中医（TCM）证候区分 RA 患者和评估预后的能力。
纳入 30 例 RA 患者和 25 名健康对照者。评估证候活动度并进行实验室检查。采用 ELISA 法检测血清中 IL-10、IL-17、IL-33 和 sST2 的水平。
RA 患者血清 sST2、IL-33 和促炎细胞因子 IL-17 水平均升高，而免疫抑制细胞因子 IL-10 水平降低。血清 IL-33 水平与 ESR、CRP 和 RF 以及 HAQ 评分、VAS 评分和 DAS28 评分呈正相关（P<0.05）。血清 sST2 水平与晨僵时间和 ESR 以及 HAQ 和 DAS28 评分相关（P<0.05）。此外，IL-33 水平与 IL-17 呈正相关（r=0.83，P<0.01），与 IL-10/IL-17 的比值呈正相关（r=0.904，P<0.01），与 IL-10 呈负相关（r=-0.632，P<0.01）。对 RA 患者进行中医证候分类，包括热证和寒证组。热证 RA 患者的炎症程度明显重于寒证患者。
IL-33 可能是监测 RA 疾病活动度和炎症状态的指标。IL-33 通过失衡 IL-10 和 IL-17 促进 RA 的发病机制。从中医角度来看，热证 RA 患者炎症更严重，疾病活动度更高，预示预后更差。
