CAJ | 학술논문

目的通过检测血清淀粉样蛋白A(SAA)在类风湿关节炎(RA)患者血清、关节液及滑膜中的表达,探讨其在RA发病机制中的作用.方法采用酶联免疫吸附试验(ELISA)分别检测RA、骨关节炎患者和健康对照人群血清以及RA与骨关节炎患者关节液中SAA的水平；蛋白印迹法测定SAA在血清中的表达；免疫组织化学技术检测RA和骨关节炎滑膜中SAA的表达.应用t检验或Kruska-Wallis秩和检验进行统计分析.结果 RA血清中SAA含量[(318±132) μg/L]显著高于骨关节炎[(127±47) μg/L]和健康对照组[(127±41) μg/L,P均＜0.01].RA关节液中SAA含量[(571±473) μg/L]显著高于骨关节炎[(129±33) μg/L,t=2.46,P=0.04].蛋白印迹法结果显示各组血清样品中均有SAA条带；RA的SAA表达明显高于其他2组.病理结果显示SAA在RA关节滑膜高表达,位于血管内皮细胞、滑膜成纤维细胞、巨噬细胞以及血管周围；在骨关节炎,SAA仅见于关节血管周围和成纤维细胞.结论 RA血清和关节液中SAA的含量显著增高；SAA在RA滑膜组织中高表达,且表达位置与骨关节炎有明显差别,提示SAA可能参与了RA的炎症反应和关节损害.
목적 통과검측혈청정분양단백A(SAA)재류풍습관절염(RA)환자혈청、관절액급활막중적표체,탐토기재RA발병궤제중적작용.방법 채용매련면역흡부시험(ELISA)분별검측RA、골관절염환자화건강대조인군혈청이급RA여골관절염환자관절액중SAA적수평；단백인적법측정SAA재혈청중적표체；면역조직화학기술검측RA화골관절염활막중SAA적표체.응용t검험혹Kruska-Wallis질화검험진행통계분석.결과 RA혈청중SAA함량[(318±132) μg/L]현저고우골관절염[(127±47) μg/L]화건강대조조[(127±41) μg/L,P균＜0.01].RA관절액중SAA함량[(571±473) μg/L]현저고우골관절염[(129±33) μg/L,t=2.46,P=0.04].단백인적법결과현시각조혈청양품중균유SAA조대；RA적SAA표체명현고우기타2조.병리결과현시SAA재RA관절활막고표체,위우혈관내피세포、활막성섬유세포、거서세포이급혈관주위；재골관절염,SAA부견우관절혈관주위화성섬유세포.결론 RA혈청화관절액중SAA적함량현저증고；SAA재RA활막조직중고표체,차표체위치여골관절염유명현차별,제시SAA가능삼여료RA적염증반응화관절손해.
Objective To investigate the role of SAA in rheumatoid arthritis (RA) pathogenesis by analyzing the expression of serum amyloid protein A(SAA) in serum,synovial fluid and synovial membrane in patients with RA.Methods SAA levels in the serum and synovial fluid in each group were detected.Sera SAA was tested by Western blotting,while the expression of SAA in RA and osteoarthritis (OA) synovium was detected by immunohistochemistry.Comparisons between groups were performed by t-tests or KruskaWallis test.Results The serum levels of SAA were significantly higher in RA [(318±132) μg/L] than those in OA [(127±47) μg/L] and healey controls [(127±41) μg/L,P＜0.01].In RA,the SAA levels in the synovial fluid [ (571±473) μg/L ] were significantly higher when compared to those in O A [ (129±33) μg/L](t=2.46,P=0.04).Western blotting results showed that SAA bands were found in the serum samples of each group,and higher expression of SAA were seen in RA.Pathology study had showed that SAA was observed mainly in endothelial cells,synovial fibroblasts,macrophages and perivascular areas in RA synovium.In OA,SAA was observed in perivascular areas and synovial fibroblasts.Conclusion In RA,SAA levels in both serum and synovial fluid are significantly higher than those in the controls.High expression of SAA in RA synovium can be observed.Our results suggest that SAA may play a role in inflammation reaction and joint destruction of RA.