CAJ | 학술논문

目的：检测类风湿关节炎（RA）患者外周血IL-25和IL-17表达水平，同时分析其与临床指标及疾病活动度评分（DAS28）的关系，初步探讨IL-25在RA中的临床意义。方法收集年龄大于16岁的80例 RA 患者及30名健康志愿者外周血标本并分组，DAS28＞3.2为 RA 活动组， DAS28≤3.2定义为RA低缓组，并进行双手关节X线Sharp总分评分及健康评估问卷（HAQ）调查；采用实时荧光定量（QRT）-PCR检测外周血单个核细胞（PBMC）中的IL-25和 IL-17的mRNA表达水平，ELISA检测血清IL-25、IL-17的蛋白浓度，并分析其与临床指标的关系；采用单因素方差分析、Spearman或Pearson相关分析和多元回归分析进行统计学处理。结果 RA活动组患者血清IL-25和IL-17蛋白浓度高于RA低缓组和健康组（P＜0.01），RA低缓组与健康组比较差异无统计学意义（P均＞0.05）。RA活动组患者PBMC中IL-25和IL-17的mRNA表达水平均高于RA低缓组和健康组（P均＜0.01），低缓组与健康组比较差异无统计学意义（P均＞0.05）。RA活动组患者血清IL-25的蛋白浓度与CRP、ESR、RF、抗CCP抗体、DAS28、Sharp总分、HAQ评分均呈正相关（P＜0.01），外周血IL-25 mRNA的表达水平亦与上述指标呈正相关（P＜0.05）。RA患者外周血IL-25的mRNA表达水平及蛋白浓度与IL-17相应水平有关（b＝0.748，P＜0.01；b＝0.843，P＜0.01）。结论 IL-25有可能参与RA的免疫炎症反应，亦有可能作为RA活动性参考指标之一。
목적：검측류풍습관절염（RA）환자외주혈IL-25화IL-17표체수평，동시분석기여림상지표급질병활동도평분（DAS28）적관계，초보탐토IL-25재RA중적림상의의。방법수집년령대우16세적80례 RA 환자급30명건강지원자외주혈표본병분조，DAS28＞3.2위 RA 활동조， DAS28≤3.2정의위RA저완조，병진행쌍수관절X선Sharp총분평분급건강평고문권（HAQ）조사；채용실시형광정량（QRT）-PCR검측외주혈단개핵세포（PBMC）중적IL-25화 IL-17적mRNA표체수평，ELISA검측혈청IL-25、IL-17적단백농도，병분석기여림상지표적관계；채용단인소방차분석、Spearman혹Pearson상관분석화다원회귀분석진행통계학처리。결과 RA활동조환자혈청IL-25화IL-17단백농도고우RA저완조화건강조（P＜0.01），RA저완조여건강조비교차이무통계학의의（P균＞0.05）。RA활동조환자PBMC중IL-25화IL-17적mRNA표체수평균고우RA저완조화건강조（P균＜0.01），저완조여건강조비교차이무통계학의의（P균＞0.05）。RA활동조환자혈청IL-25적단백농도여CRP、ESR、RF、항CCP항체、DAS28、Sharp총분、HAQ평분균정정상관（P＜0.01），외주혈IL-25 mRNA적표체수평역여상술지표정정상관（P＜0.05）。RA환자외주혈IL-25적mRNA표체수평급단백농도여IL-17상응수평유관（b＝0.748，P＜0.01；b＝0.843，P＜0.01）。결론 IL-25유가능삼여RA적면역염증반응，역유가능작위RA활동성삼고지표지일。
Objective To measure the expression levels of interleukin (IL)-25 and IL-17 in pe-ripheral blood of patients with rheumatoid arthritis (RA)and analyze the relationship between IL-25 ,and clini-cal index and the disease activity index 28 (DAS 28)scores in RA patients. The aim of this study is to identify the clinical significance of IL-25 in RA patients. Methods Peripheral blood samples were collected from 80 RA patients and 30 healthy volunteers. All subjects were above 16 years old. Fifty RA patients with DAS 28 score>3.2 were assigned into the RA active group and 30 with DAS 28 score≤3.2 were allocated into the RA inactive group. Hands joint X-ray total Sharp score and Health Assessment Questionnaire (HAQ)were recor-ded. The mRNA levels of IL-25/IL-25R and IL-17 in the peripheral blood mononuclear cells (PBMC)were determined by quantitative real-time PCR (QRT-PCR). The serum IL-25 and IL-17 proteins were detected by enzyme-linked immunosorbent assay (ELISA ). One-way ANOVA,Spearman’s or Pearson’s correlation and multiple linear regression were adopted to perform statistical analysis. Results The serum IL-25 and IL-17 proteins in the RA active group was significantly higher than those in the RA inactive and control groups (P<0.01),whereas no statistical significance was noted between the RA inactive and control groups (P>0.05).The mRNA levels of IL-25 and IL-17 in the RA active group were higher compared with those in the RA inac-tive and control groups (P<0.01),whereas no significant difference was found between the RA inactive and control groups (P>0.05 ). The potein level of serum IL-25 was positively correlated with the levels of CRP,ESR,RF,anti-CCP antibody,DAS 28,total Sharp score,HAQ (P<0.01 ),and the same outcome was found in the mRNA levels of IL-25 in PBMC (P<0.05 ). Both mRNA and protein levels of IL-25 were posi-tively correlated with corresponding IL-17 levels (b=0.748,P<0.01;b=0.843,P<0.01). Conclusion IL-25 in PBMC was probably involved with RA immune inflammation and it may serve as indicator of the activi-ty of RA.