中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
6期
472-476
,共5页
李瑞娟%唐雪梅%刘玮%周娟%安云飞%秦仕英%邹宗毅
李瑞娟%唐雪梅%劉瑋%週娟%安雲飛%秦仕英%鄒宗毅
리서연%당설매%류위%주연%안운비%진사영%추종의
白细胞介素6%趋化因子CXCL10%白细胞介素17%幼年特发性关节炎
白細胞介素6%趨化因子CXCL10%白細胞介素17%幼年特髮性關節炎
백세포개소6%추화인자CXCL10%백세포개소17%유년특발성관절염
Interleukin-6%Chemokine CXCL10%Interleukin-17%Juvenile idiopathic arthritis
目的 研究幼年特发性关节炎(JIA)患儿外周血及关节液中白介素6(IL-6)、γ干扰素诱导蛋白10(IP-10)及白介素17(IL-17)的表达差异.方法 收集JIA患儿血清27例[其中全身型JIA (sJIA) 13例、多关节型JIA(pJIA) 14例]及关节液18例；疑诊sJIA患儿血清19例.另收集健康体检儿童血清28例作为对照.采用酶联免疫吸附法检测血清及关节液上清IL-6、IP-10及IL-17的浓度.结果 (1)血清细胞因子浓度:sJIA组血清IL-6浓度明显高于健康对照组[28.0(4.2 ～59.2)ng/L vs.12.3(2.1 ～ 13.8) ng/L,P＜0.05],但疑诊sJIA组与健康对照组相比无明显升高[11.8(7.7～39.2)ng/Lvs.12.3(2.1 ～13.8)ng/L,JP＞0.05].sJIA组血清IL-17浓度高于健康对照组[14.0(9.8～ 34.3)ng/L vs.9.8(7.9 ～ 16.2)ng/L,P＜0.05],pJIA组血清IL-17浓度与健康对照组相比无明显升高[14.2(9.9 ～ 16.9)ng/L vs.9.8(7.9 ～ 16.2)ng/L,P＞0.05].(2) sJIA及pJIA组关节液中IP-10的浓度均分别高于两组血清[619.7(160.9,873.1)ng/L vs.64.8(27.4 ～ 111.9) ng/L,P＜0.01；660.9(401.9,1349.8)ng/L vs.97.4(41.9 ～222.1)ng/L,P＜0.01].关节液中IL-17浓度仅pJIA组显著高于血清[22.9(17.1,45.8) ng/L vs.14.2(9.9 ～ 16.9)ng/L,P＜0.01].结论 (1)IL-6在sJIA发病中起重要作用,并且可能成为关节炎症早期的重要生物学标记.(2) sJIA发病机制中可能共同存在自身炎症反应和自身免疫反应.(3) IL-17在pJIA关节液局部高表达,而在外周血表达并不升高.(4)趋化因子IP-10在关节液和外周血中存在显著浓度梯度,可能是其发挥趋化作用,进而致sJIA关节损害的基础.
目的 研究幼年特髮性關節炎(JIA)患兒外週血及關節液中白介素6(IL-6)、γ榦擾素誘導蛋白10(IP-10)及白介素17(IL-17)的錶達差異.方法 收集JIA患兒血清27例[其中全身型JIA (sJIA) 13例、多關節型JIA(pJIA) 14例]及關節液18例；疑診sJIA患兒血清19例.另收集健康體檢兒童血清28例作為對照.採用酶聯免疫吸附法檢測血清及關節液上清IL-6、IP-10及IL-17的濃度.結果 (1)血清細胞因子濃度:sJIA組血清IL-6濃度明顯高于健康對照組[28.0(4.2 ～59.2)ng/L vs.12.3(2.1 ～ 13.8) ng/L,P＜0.05],但疑診sJIA組與健康對照組相比無明顯升高[11.8(7.7～39.2)ng/Lvs.12.3(2.1 ～13.8)ng/L,JP＞0.05].sJIA組血清IL-17濃度高于健康對照組[14.0(9.8～ 34.3)ng/L vs.9.8(7.9 ～ 16.2)ng/L,P＜0.05],pJIA組血清IL-17濃度與健康對照組相比無明顯升高[14.2(9.9 ～ 16.9)ng/L vs.9.8(7.9 ～ 16.2)ng/L,P＞0.05].(2) sJIA及pJIA組關節液中IP-10的濃度均分彆高于兩組血清[619.7(160.9,873.1)ng/L vs.64.8(27.4 ～ 111.9) ng/L,P＜0.01；660.9(401.9,1349.8)ng/L vs.97.4(41.9 ～222.1)ng/L,P＜0.01].關節液中IL-17濃度僅pJIA組顯著高于血清[22.9(17.1,45.8) ng/L vs.14.2(9.9 ～ 16.9)ng/L,P＜0.01].結論 (1)IL-6在sJIA髮病中起重要作用,併且可能成為關節炎癥早期的重要生物學標記.(2) sJIA髮病機製中可能共同存在自身炎癥反應和自身免疫反應.(3) IL-17在pJIA關節液跼部高錶達,而在外週血錶達併不升高.(4)趨化因子IP-10在關節液和外週血中存在顯著濃度梯度,可能是其髮揮趨化作用,進而緻sJIA關節損害的基礎.
목적 연구유년특발성관절염(JIA)환인외주혈급관절액중백개소6(IL-6)、γ간우소유도단백10(IP-10)급백개소17(IL-17)적표체차이.방법 수집JIA환인혈청27례[기중전신형JIA (sJIA) 13례、다관절형JIA(pJIA) 14례]급관절액18례；의진sJIA환인혈청19례.령수집건강체검인동혈청28례작위대조.채용매련면역흡부법검측혈청급관절액상청IL-6、IP-10급IL-17적농도.결과 (1)혈청세포인자농도:sJIA조혈청IL-6농도명현고우건강대조조[28.0(4.2 ～59.2)ng/L vs.12.3(2.1 ～ 13.8) ng/L,P＜0.05],단의진sJIA조여건강대조조상비무명현승고[11.8(7.7～39.2)ng/Lvs.12.3(2.1 ～13.8)ng/L,JP＞0.05].sJIA조혈청IL-17농도고우건강대조조[14.0(9.8～ 34.3)ng/L vs.9.8(7.9 ～ 16.2)ng/L,P＜0.05],pJIA조혈청IL-17농도여건강대조조상비무명현승고[14.2(9.9 ～ 16.9)ng/L vs.9.8(7.9 ～ 16.2)ng/L,P＞0.05].(2) sJIA급pJIA조관절액중IP-10적농도균분별고우량조혈청[619.7(160.9,873.1)ng/L vs.64.8(27.4 ～ 111.9) ng/L,P＜0.01；660.9(401.9,1349.8)ng/L vs.97.4(41.9 ～222.1)ng/L,P＜0.01].관절액중IL-17농도부pJIA조현저고우혈청[22.9(17.1,45.8) ng/L vs.14.2(9.9 ～ 16.9)ng/L,P＜0.01].결론 (1)IL-6재sJIA발병중기중요작용,병차가능성위관절염증조기적중요생물학표기.(2) sJIA발병궤제중가능공동존재자신염증반응화자신면역반응.(3) IL-17재pJIA관절액국부고표체,이재외주혈표체병불승고.(4)추화인자IP-10재관절액화외주혈중존재현저농도제도,가능시기발휘추화작용,진이치sJIA관절손해적기출.
Objective To detect the disparity of three cytokines interleukin-6 (IL-6),interferoninducible protein 10 (IP-10) and interleukin-17 (IL-17) in peripheral blood (PB) and synovial fluid (SF) of patients with juvenile idiopathic arthritis (JIA).Method Serum concentrations of the three cytokines were measured in 27 patients with 13 systemic-onset JIA (sJIA),14 polyarticular JIA (pJIA) and 28 healthy controls using enzyme-linked immunosorbent assay (ELISA).Nineteen patients with no marked arthritis symptom or only temporary arthralgia were enrolled in probable sJIA group.SF from 18 patients with 7 sJIA,11 pJIA were examined for cytokine levels.Result (1) The statistically significant difference in serum IL-6 was detected between sJIA and healthy control group [28.0(4.2-59.2) ng/L vs.12.3 (2.1-13.8) ng/L,P ＜ 0.05],but no significant difference between probable sJIA and healthy control group [11.8 (7.7-39.2)ng/L vs.12.3 (2.1-13.8) ng/L,P ＞ 0.05] was found.There were statistically significant differences between sJIA group and healthy control group in serum concentrations of IL-17 [14.0(9.8-34.3) ng/L vs.9.8 (7.9-16.2) ng/L,P ＜ 0.05],yet compared to healthy control group,no significant difference in concentration level of IL-17 was found in pJIA Group [14.2(9.9-16.9) ng/L vs.9.8(7.9-16.2) ng/L,P ＞ 0.05].(2) In sJIA and pJIA SF,the median IP-10 level was significantly higher compared to respective PB levels [619.7 (160.9,873.1) ng/L vs.64.8 (27.4-111.9) ng/L;660.9 (401.9,1349.8) ng/L vs.97.4 (41.9-222.1) ng/L,P ＜ 0.01,respeetively],but there was only significant difference in IL-17 between pJIA SF and PB[22.9 (17.1,45.8) ng/L vs.14.2 (9.9-16.9) ng/L,P ＜0.01].Conclusion IL-6 may play more important role in the pathogenesis of sJIA.Moreover,IL-6 may be the biomarker associated with arthritis in early JIA stage.Both autoinflammation and autoimmune response may be involved in the pathogenesis of sJIA.IL-17 enrichment may only occur in local joint,the levels of IL-17 in PB may not be significantly increased.The prominent expression gradient between SF and PB of IP-10 maybe the basis of performing chemotaxis and further causing joint damage.
