Yan Dawei, Wan Lei, Zhang Mengyu, Wang Siyu, Li Feng
Department of Rheumatology, First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei 230031; Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Hefei 230012, China.
Department of Rheumatology, First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei 230031; Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine of IHM, Hefei 230012; Key Laboratory of Xin'an Medicine, Ministry of Education, Hefei 230012, China. *Corresponding author, E-mail:
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2024 Aug;40(8):715-722.
Objective To measure the serum contents of cytokines in patients with rheumatoid arthritis (RA) and explore the clinical application value of combined detection of inflammatory cytokines in evaluating the severity of RA. Methods This study recruited 28 RA patients and 15 healthy individuals who received health checkups during the same period. The expression of inflammatory cytokines including interleukin 1β (IL-1β), IL-2, IL-5, IL-6, IL-8, IL-12P70, IL-17, tumor necrosis factor-α (TNF-α), interferon α (IFN-α), IFN-γ, IL-4 and IL-10 were detected with the multiplexed microsphere-based flow cytometric immunoassay. C-reactive protein (CRP) was detected with an automatic biochemical instrument, and erythrocyte sedimentation rate (ESR) was measured by the Westergren method. The disease activity score in 28 joints (DAS28) in the RA group was calculated, and the area under the curve (AUC) of each cytokine and RA disease activity was compared. The correlation of serum levels of inflammatory cytokines with CRP and ESR was analyzed in RA patients. Results In RA patients, the serum levels of IL-2, IL-6, IL-12P70, IL-4 and IL-10 were significantly correlated with the indicator of RA disease activity DAS28-CRP, and the serum levels of IL-12P70, TNF-α and IL-4 were markedly correlated with the indicator of RA disease activity DAS28-ESR. CRP was positively correlated with IL-6 (r=0.515), IL-12P70 (r=0.530), IL-4 (r=0.539), and IL-10(r=0.434). ESR was positively correlated with IL-6 (r=0.403), IL-12P70 (r=0.475), TNF-α (r=0.497), and IL-4 (r=0.450). Compared with the normal CRP and ESR group, the abnormal CRP group showed an increase in the levels of IL-6, IL-12P70, IL-2, IL-4 and IL-10, and the abnormal ESR group exhibited an elevation in the levels of IL-12P70, IL-4 and TNF-α. The expression of IL-8, IFN-α and IFN-γ was higher in the experimental group than in the control group. Conclusion Serum inflammatory cytokines detection has shed light on the early diagnosis and severity evaluation of RA and can be used as a pivotal indcator for the diagnosis of RA.
目的 检测类风湿关节炎（RA）患者血清细胞因子含量，探讨联合检测炎症细胞因子在评估RA病情严重程度中的临床应用价值。方法 本研究纳入28例RA患者及同期进行健康体检的15名健康个体。采用基于微球的流式细胞免疫分析技术检测炎症细胞因子白细胞介素1β（IL-1β）、IL-2、IL-5、IL-6、IL-8、IL-12P70、IL-17、肿瘤坏死因子-α（TNF-α）、干扰素α（IFN-α）、IFN-γ、IL-4和IL-10的表达。用自动生化分析仪检测C反应蛋白（CRP），采用魏氏法测定红细胞沉降率（ESR）。计算RA组28个关节疾病活动评分（DAS28），比较各细胞因子与RA疾病活动度的曲线下面积（AUC）。分析RA患者血清炎症细胞因子水平与CRP、ESR的相关性。结果 在RA患者中，IL-2、IL-6、IL-12P70、IL-4和IL-10的血清水平与RA疾病活动指标DAS28-CRP显著相关，IL-12P70、TNF-α和IL-4的血清水平与RA疾病活动指标DAS28-ESR显著相关。CRP与IL-6（r=0.515）、IL-12P70（r=0.530）、IL-4（r=0.539）和IL-10（r=0.434）呈正相关。ESR与IL-6（r=0.403）、IL-12P70（r=0.475）、TNF-α（r=0.497）和IL-4（r=0.450）呈正相关。与CRP和ESR正常组相比，CRP异常组IL-6、IL-12P70、IL-2、IL-4和IL-10水平升高，ESR异常组IL-12P70、IL-4和TNF-α水平升高。实验组IL-8、IFN-α和IFN-γ的表达高于对照组。结论 血清炎症细胞因子检测有助于RA的早期诊断和病情严重程度评估，可作为RA诊断的关键指标。
