Th1/Th2细胞因子谱在类风湿关节炎患者外周血和关节积液中的表达及意义  

Th1/Th2 cytokines' profile in peripheral blood and synovial fluid of patients with rheumatoid arthritis

作　　者：李景怡[1,2] 方勇飞[2] 邹丽云[1] 张晋宇[1] 傅晓岚[1] 柏干苹[2] 万瑛[1] 吴玉章[1] 

机构地区：[1]第三军医大学基础医学部全军免疫学研究所,重庆400038 [2]第三军医大学西南医院风湿病中心,重庆400038

出　　处：《第三军医大学学报》2010年第18期1921-1924,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金(30801030)~~

摘　　要：目的鉴定类风湿关节炎患者外周血和关节积液中Th1/Th2细胞因子谱的表达并探讨其在炎症中的意义。方法采用微量样本多指标流式蛋白定量技术(cytometric bead array,CBA)检测41例类风湿关节炎(rheumatoid arthritis,RA)患者(2006年1月至2007年12月西南医院风湿病中心首诊病例)血清和关节积液中IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ的表达。对照组(n=5)为西南医院健康查体人员。结果与对照组和/或RA患者外周血比较,RA患者关节积液中IL-2、IL-4、IFN-γ、IL-6和IL-10的表达显著增高(P<0.01),IFN-γ和IL-6的表达在RA患者外周血中也显著增高(P<0.01),TNF-α的表达在RA患者关节积液和外周血中也增高(P<0.05),并且在关节积液中IFN-γ/IL-4比例显著增高(P<0.01)。与抗环瓜氨酸肽抗体(cyclic citrullinated peptide,CCP)阴性的患者相比,CCP抗体阳性的患者关节积液中IL-2、IL-6表达增高(P<0.05),TNF-α和IFN-γ的表达显著增高(P<0.01)。结论Th1/Th2极化失衡是RA炎症损伤的主要免疫病理机制,在关节局部是以Th1极化诱导的炎症反应为主,并且CCP抗体阳性患者关节炎症程度明显高于CCP抗体阴性患者。Objective To investigate the expressions and significances of Th1/Th2 cytokines in the peripheral blood（PB）and synovial fluid（SF）of patients with rheumatoid arthritis（RA）.Methods Totally 15 PB samples and 36 knee joint SF were collected from 41 RA patients who diagnosed for the first time in our department from January 2006 to December 2007.They all were diagnosed as RA according to the diagnostic criteria of American College of Rheumatology（ACR）and received no any immunosuppressive treatment.Another 5 samples from health individuals served as normal control.Expressions of IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ were examined by cytometric bead array（CBA）.Serum expression of cyclic citrullinated peptide（CCP）was measured by ELISA.Results Expressions of IL-2（6.32±0.34 pg/ml）,IL-4（5.83±0.30 pg/ml）,IFN-γ（18.62±11.52 pg/ml）,IL-6（6 217.78±4 336.18 pg/ml）and IL-10（35.28±8.02 pg/ml）were significantly increased in the SF of RA patients（P〈0.01）.Expression of IFN-γ（18.62±11.52 pg/ml）was significantly increased in PB of RA patients（P〈0.01）.Expression of TNF-α was increased in SF（17.34±4.78 pg/ml）and PB（29.48±14.26 pg/ml）of RA patients（P〈0.05）.Furthermore,ratio of IFN-γ/IL-4（3.34±0.42）was significantly increased in SF than in PB of RA and healthy donor（P〈0.01）.Moreover,compared with CCP-negative patients,the expressions of IL-2（5.41±1.37 pg/ml）and IL-6（5 360.21±3 705.78 pg/ml）were increased（P〈0.05）,and the expressions of TNF-α（15.99±3.75 pg/ml）and IFN-γ（29.04±12.46 pg/ml）were very significantly increased in CCP-positive patients（P〈0.01）.Conclusion Altered polarization of Th1/Th2 is the principal mechanism of immunopathogenesis in RA.In topical part of arthritis,Th1 polarization induces the inflammation.Furthermore,inflammation of arthritis may be more severe in CCP-positive RA patients than negative ones.

关 键 词：类风湿关节炎 TH1细胞 TH2细胞 抗环瓜氨酸肽抗体 

分 类 号：R593.22[医药卫生—内科学] R392-33[医药卫生—临床医学]