关节液Th17细胞变化在类风湿关节炎免疫炎症中的作用  

The Role of T Helper 17 Cells of Synovial Fluid in Rheumatoid Arthritis

作　　者：林辉[1] 周燕莉[2] 李箭[3] 李宇娟[3] 赵毅[1] 严冰[1] 刘毅[1] 

机构地区：[1]四川大学华西医院风湿免疫科,成都610041 [2]泸州医学院风湿科,泸州646000 [3]四川大学华西医院骨科,成都610041

出　　处：《四川大学学报（医学版）》2013年第6期907-910,共4页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金项目(No.81102274);成都市科技攻关项目(No.10GGYB644SF-023)资助

摘　　要：目的检测类风湿关节炎(RA)患者外周血和关节液Th17细胞的变化,探讨该细胞亚群在RA免疫炎症机制中的作用。方法采用流式细胞术检测15例RA患者外周血、关节液及15例健康对照外周血Th17细胞比例;分析RA患者关节液Th17细胞比例与临床炎症指标的相关性;通过real-time PCR检测外周血和关节液淋巴细胞维甲酸相关孤儿受体γt(RORγt)、白细胞介素(IL)-17基因表达。结果①活动期RA患者关节液Th17细胞比例〔(1.89±0.88)%〕高于配对外周血〔(1.03±0.57)%〕和健康对照组〔(0.35±0.18)%〕,差异有统计学意义(P<0.01);②RA患者关节液Th17细胞比例与血清C反应蛋白(CRP)呈正相关(r=0.519,P=0.047);③活动期RA患者关节液淋巴细胞RORγt、IL-17基因表达水平均高于配对外周血和健康对照组(P<0.01)。结论 RA患者关节液中Th17细胞的变化反映了RA关节炎症和系统炎症的差异,揭示了关节损伤的机制。Objective To investigate the role of Thl7 cells of synovial fluid （SF）in the pathogenesis of rheumatoid arthritis （RA）. Methods RA patients with knee synovial fluid （n：15）and healthy volunteers（n=15） were enrolled. The amounts of Thl7 cells in peripheral blood and SF were measured by flow cytometry. Since there was no SF in healthy control, only the amounts of Thl7 ceils in peripheral blood were measured. The correlation between the amounts of SF Thl7 cells and clinical inflammatory parameters was evaluated. Retinoic acid-related orphan receptor gammat （RORTt）, interleukin-17 （IL-17） gene expression in lymphocytes were assessed by real- time PCR. Results ① The percentages of Th17 cells in SF from RA patients （1. 89 ± 0.88）% were significantly higher than that in paired PB from RA patients （1.03 ± 0. 57）%and that in PB from healthy controls （0. 35 ± 0. 18）% ;②The frequency of Thl7 cells in SF from RA patients correlated positively with serum CRP （r： 0. 519, P=0. 047） ;③ The mRNA levels of RORyt and IL-17 were increased in SF lymphocyte population from RA patients compared to paired PB from RA patients and healthy controls （P〈0. 01）. Conclusion Increases of Th17 cells in synovial fluid of patients with RA patients might attribute to the difference between local joint inflammation and systemic inflammation, and participates in joint damage.

关 键 词：TH17细胞 关节液类风湿关节炎 流式细胞术 

分 类 号：R593.22[医药卫生—内科学]