血清p55和p75肿瘤坏死因子受体作为青少年慢性关节炎疾病活动的标志物。
Serum p55 and p75 tumour necrosis factor receptors as markers of disease activity in juvenile chronic arthritis.
作者信息
Gattorno M, Picco P, Buoncompagni A, Stalla F, Facchetti P, Sormani M P, Pistoia V
机构信息
II Division of Paediatrics, 'G Gaslini' Scientific Institute for Children, Genoa, Italy.
出版信息
Ann Rheum Dis. 1996 Apr;55(4):243-7. doi: 10.1136/ard.55.4.243.
OBJECTIVE
To determine the expression of tumour necrosis factor alpha (TNF alpha) and its soluble receptors (p55 and p75) in the sera and synovial fluid of patients with juvenile chronic arthritis (JCA), and their correlation with disease activity parameters.
METHODS
Ninety eight sera from 45 patients with JCA (14 systemic, 12 polyarticular, 19 pauciarticular), 20 sera from age matched healthy controls, and five synovial fluids from five antinuclear antibody (ANA) positive pauciarticular JCA patients were tested for the presence of TNF alpha, soluble TNF receptors p55 and p75 (sTNFRp55, sTNFRp75), and interleukin-6 (IL-6) by an enzyme amplified sensitivity immunoassay. Physician global estimate of disease activity, weekly fever score and joint score, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and haemoglobin concentration were evaluated as parameters of disease activity. The expression of p55 and p75 on peripheral mononuclear cells (MNCs) from five patients with systemic JCA and synovial MNCs from five ANA positive patients with pauciarticular JCA was evaluated by flow cytometry.
RESULTS
TNF alpha serum concentrations did not differ significantly between the patients with active JCA and the control group. No correlation was found between TNF alpha and parameters of disease activity, but both p55 and p75 showed a significant positive correlation with the physician global estimate of disease activity (p < 0.001), ESR (p < 0.001), CRP (p < 0.001), and serum concentrations of IL-6 (p < 0.001). Serum concentrations of haemoglobin correlated inversely with the concentrations of p55 and p75 (p < 0.001). Synovial lymphocytes selectively expressed the p75 surface receptor.
CONCLUSIONS
sTNFRp55 and sTNFRp75 each represent a sensitive marker of disease activity in JCA. Their increased expression in biological fluids may support the hypothesis that TNF alpha has a role in the pathogenesis of JCA.
目的
测定青少年慢性关节炎（JCA）患者血清及滑液中肿瘤坏死因子α（TNFα）及其可溶性受体（p55和p75）的表达，并探讨其与疾病活动参数的相关性。
方法
采用酶放大敏感性免疫分析法检测45例JCA患者（14例全身型、12例多关节型、19例少关节型）的98份血清、20例年龄匹配的健康对照者的血清以及5例抗核抗体（ANA）阳性少关节型JCA患者的5份滑液中TNFα、可溶性TNF受体p55和p75（sTNFRp55、sTNFRp75）及白细胞介素-6（IL-6）的存在情况。评估医生对疾病活动的整体评估、每周发热评分和关节评分、C反应蛋白（CRP）、红细胞沉降率（ESR）及血红蛋白浓度作为疾病活动参数。采用流式细胞术评估5例全身型JCA患者外周血单个核细胞（MNCs）及5例ANA阳性少关节型JCA患者滑膜MNCs上p55和p75的表达。
结果
活动期JCA患者与对照组血清TNFα浓度无显著差异。未发现TNFα与疾病活动参数之间存在相关性，但p55和p75均与医生对疾病活动的整体评估（p<0.001）、ESR（p<0.001）、CRP（p<0.001）及血清IL-6浓度（p<0.001）呈显著正相关。血红蛋白血清浓度与p55和p75浓度呈负相关（p<0.001）。滑膜淋巴细胞选择性表达p75表面受体。
结论
sTNFRp55和sTNFRp75均代表JCA疾病活动的敏感标志物。它们在生物体液中的表达增加可能支持TNFα在JCA发病机制中起作用的假说。
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