Jin Yaxiong, Guo Yixue, Ding Bin, Tang Ling, Zhang Chunying, Fu Yang, He Yong, Niu Qian
Department of Laboratory Medicine, West China Hospital, Chengdu, Sichuan, China.
Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, Sichuan, China.
Int J Rheum Dis. 2025 Mar;28(3):e70151. doi: 10.1111/1756-185X.70151.
This article analyzed the relationship between serum sIL-2R levels and Th17/Treg immune balance in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and their prognostic value.
RA patients (n = 311) were retrospectively selected for research and then allocated to the RA and RA-ILD groups. Baseline data and 3-year follow-up records of all patients were attained to assess disease progression. Serum sIL-2R levels were examined with ELISA, and Th17 and Treg cell clusters were tested with flow cytometry, followed by the calculation of the Th17/Treg ratio. The correlation of serum sIL-2R with Th17/Treg and related cytokines (IL-17, IL-6, IL-10, and TGF-β1) in RA-ILD patients were analyzed with Spearman's analysis. ROC curves were plotted for analyzing the performance of serum sIL-2R levels and the Th17/Treg ratio for predicting disease progression in RA-ILD patients. A multivariate Cox regression model was developed to screen independent risk factors for disease progression in RA-ILD patients.
RA-ILD patients had elevated serum levels of sIL-2R, Th17 cells, IL-17, and IL-6 and an increased ratio of Th17/Treg, accompanied by a decreased Treg cell population and IL-10 and TGF-β1 levels. Serum sIL-2R levels were correlated positively with IL-17 levels and the Th17/Treg ratio in RA-ILD patients and negatively with IL-10 levels. DAS28 scores, serum sIL-2R levels, and an elevated Th17/Treg ratio were independent risk factors for disease progression in RA-ILD patients, and increased FEV1 and FEV1/FVC were protective factors.
Serum sIL-2R levels in conjunction with Th17/Treg immune balance can assist in predicting 3-year disease progression in RA-ILD patients.
本文分析了类风湿关节炎相关间质性肺病（RA-ILD）患者血清可溶性白细胞介素-2受体（sIL-2R）水平与Th17/Treg免疫平衡之间的关系及其预后价值。
回顾性选取311例类风湿关节炎（RA）患者进行研究，然后将其分为RA组和RA-ILD组。获取所有患者的基线数据和3年随访记录以评估疾病进展。采用酶联免疫吸附测定（ELISA）检测血清sIL-2R水平，采用流式细胞术检测Th17和Treg细胞亚群，随后计算Th17/Treg比值。采用Spearman分析方法分析RA-ILD患者血清sIL-2R与Th17/Treg及相关细胞因子（白细胞介素-17（IL-17）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）和转化生长因子-β1（TGF-β1））之间的相关性。绘制受试者工作特征（ROC）曲线，分析血清sIL-2R水平和Th17/Treg比值对RA-ILD患者疾病进展的预测效能。建立多因素Cox回归模型，筛选RA-ILD患者疾病进展的独立危险因素。
RA-ILD患者血清sIL-2R、Th17细胞、IL-17和IL-6水平升高，Th17/Treg比值增加，同时Treg细胞数量、IL-10和TGF-β1水平降低。RA-ILD患者血清sIL-2R水平与IL-17水平及Th17/Treg比值呈正相关，与IL-10水平呈负相关。疾病活动评分28（DAS28）、血清sIL-2R水平及升高的Th17/Treg比值是RA-ILD患者疾病进展的独立危险因素，而第1秒用力呼气容积（FEV1）增加和FEV1/用力肺活量（FVC）增加是保护因素。
血清sIL-2R水平联合Th17/Treg免疫平衡有助于预测RA-ILD患者3年疾病进展情况。
