Kamper E F, Kopeikina L T, Koutsoukos V, Stavridis J
Department of Experimental Physiology, Medical School, University of Athens, Greece.
J Rheumatol. 1997 Feb;24(2):262-8.
We investigated alterations of levels of plasma tetranectin, a new regulator of plasminogen activation, in patients with rheumatoid arthritis (RA) in relation to disease activity and other fibrinolytic variables.
Tetranectin (TN), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor (PAI-1) were quantitatively assessed (ELISA) in plasma of 41 patients with RA and 30 healthy subjects, alpha 2-Antiplasmin activity was assessed by the amidolytic method. Disease activity was determined as a composite Stoke Index, which measures inflammatory processes in RA. Patients were divided into 3 groups according to Stoke Index score of disease activity: A, minimal-mild, 1-7: B. moderate. 8-11: C. severe. 12-17.
Plasma TN in patients was significantly lower compared to that of healthy subjects [9.11 (4.97-13.49) mg/l, 12.05 (9.50-13.60) mg/l, median (range), respectively; p = 0.0001]. TN decreases with the increase of disease activity from group to group. A significant negative correlation between TN and Stoke Index. C-reactive protein and erythrocyte sedimentation rate was found (rs = -0.49, p = 0.0012; rs = -0.44, p = 0.0044; rs = -0.37, p = 0.016, respectively). alpha 2-Antiplasmin activity was elevated in patients compared to healthy subjects [105.0% (53.0-146.0), 70.6% (48.2-124.0), median (range), respectively; p = 0.0001], showing a negative correlation with Stoke Index (rs = -0.38, p = 0.0139). The close positive correlation of TN with alpha 2-antiplasmin (rs = 0.66, p = 0.0001) and the absence of correlation with t-PA and PAI-1 were explained by the involvement of TN and alpha 2-antiplasmin in localized rather than in systemic fibrinolysis.
Our findings suggest TN plays a role in the pathophysiology of RA and point to the usefulness of TN assessment as a specific fibrinolytic marker in the evaluation of disease activity in patients with RA. The role of TN in the intraarticular regulation of fibrinolysis, important for the expansion of pannus, tissue remodeling and angiogenesis, is discussed.
我们研究了类风湿关节炎（RA）患者血浆纤连蛋白水平的变化，纤连蛋白是纤溶酶原激活的一种新调节因子，探讨其与疾病活动度及其他纤维蛋白溶解变量的关系。
采用酶联免疫吸附测定法（ELISA）对41例RA患者和30例健康受试者的血浆纤连蛋白（TN）、组织型纤溶酶原激活剂（t-PA）和纤溶酶原激活物抑制剂（PAI-1）进行定量评估，采用酰胺水解法评估α2-抗纤溶酶活性。疾病活动度通过综合斯托克指数来确定，该指数用于衡量RA中的炎症过程。根据疾病活动度的斯托克指数评分将患者分为3组：A组，轻度，1 - 7分；B组，中度，8 - 11分；C组，重度，12 - 17分。
与健康受试者相比，患者血浆TN水平显著降低[分别为9.11（4.97 - 13.49）mg/l和12.05（9.50 - 13.60）mg/l，中位数（范围）；p = 0.0001]。TN水平随疾病活动度从一组到另一组增加而降低。发现TN与斯托克指数、C反应蛋白和红细胞沉降率之间存在显著负相关（rs = -0.49，p = 0.0012；rs = -0.44，p = 0.0044；rs = -0.37，p = 0.016）。与健康受试者相比，患者α2-抗纤溶酶活性升高[分别为105.0%（53.0 - 146.0）和70.6%（48.2 - 124.0），中位数（范围）；p = 0.0001]，与斯托克指数呈负相关（rs = -0.38，p = 0.0139）。TN与α2-抗纤溶酶密切正相关（rs = 0.66，p = 0.0001），与t-PA和PAI-1无相关性，这是由于TN和α2-抗纤溶酶参与局部而非全身纤维蛋白溶解所致。
我们的研究结果表明TN在RA的病理生理学中起作用，并指出TN评估作为评估RA患者疾病活动度的特异性纤维蛋白溶解标志物的有用性。讨论了TN在关节内纤维蛋白溶解调节中的作用，这对血管翳扩展、组织重塑和血管生成很重要。
