基于NF-κB及细胞因子的变化探讨骨关节炎患者高凝状态的机制  

Exploring the mechanism of hypercoagulability in osteoarthritis patients based on the change of NF-κB and cytokines

作　　者：谈冰[1] 刘健[2] 章平衡 方利[1] 朱福兵 

机构地区：[1]安徽中医药大学研究生部,合肥230038 [2]安徽医科大学第一附属医院风湿科,合肥230031

出　　处：《免疫学杂志》2015年第10期882-887,共6页Immunological Journal

基　　金：国家临床重点专科中医风湿病科建设项目(财社[2013]239号);国家中医药重点学科中医痹病学建设项目(国中医药发[2009]30号);"十二五"国家科技支撑计划项目(2012BAI26B02);安徽省重点实验室建设项目(1306c083035);安徽省科技计划项目(11010402170)

摘　　要：目的研究骨关节炎(OA)患者血清中p50、p65、TAK1、NF-κB抑制因子(IκBα)、细胞因子及凝血指标的变化并进行相关性研究。方法对40例OA患者及9例正常对照分别抽取静脉血,离心分离血清,用酶联免疫吸附法测定血清中的p50、p65、TAK1、IκBα及IL-1、TNF-α、IL-10、血小板活化因子(PAF)的表达水平,并测定凝血指标、实验室指标的水平,观察2组之间的变化并进行相关性分析。结果 1与健康对照组比较,OA组PT、PAF-AH明显缩短,PLT、FIB、D-D、PAF水平显著升高(P<0.05或P<0.01)。2与健康对照组比较,OA组血清p50、p65、TAK1、IκBα水平显著升高(P<0.05或P<0.01)。OA患者细胞因子IL-1、TNF-α和炎症、免疫指标hs-CRP、ESR、Ig G显著升高(P<0.01),细胞因子IL-10显著降低(P<0.05)。3PLT、FIB、D-D、PAF与p50、p65、TAK1、IL-1、TNF-α、hs-CRP、ESR、Ig G、Lequesne MG、症状量化积分、VAS积分表达成正相关,与IL-10、SF-36各维度积分成负相关(P<0.05或P<0.01)。PT与IL-10、GH、PF成正相关,与p50、p65、TAK1、IL-1、TNF-α、hs-CRP、ESR、Ig G、症状量化积分、VAS积分成负相关(P<0.05或P<0.01)。APTT与GH成正相关,与TAK1、Lequesne MG成负相关(P<0.05或P<0.01)。TT与MH成正相关,与IL-1、Lequesne MG成负相关(P<0.05或P<0.01)。结论 OA患者体内存在高凝状态,并与细胞因子及NF-κB信号通路有关,提示NF-κB信号通路的异常活化,细胞因子失衡及免疫功能的紊乱,可能是凝血-纤溶系统失衡的原因之一,对OA的发生及发展有重大关系。The study was designed to explore the changes and the correlation of P50, p65, TAK1, NF-κB inhibitor（IκBα）, cytokines and the blood coagulation related-indicators in patients with osteoarthritis（OA） for evaluating the mechanism of hypercoagulability in OA patients. Total of 40 OA patients were enrolled in this study and 9 healthy people were selected as normal control. ELISA was used to detect the levels of p50, p65, TAK1, IκBαand IL-1, TNF-α, IL-10, platelet activating factor（PAF） in serum, and the levels of the coagulation related indicators was detected. At the same time, we observed the difference of the above indicators between the two groups and their correlations. We found that the time of PT and PAF-AH were significantly shortened, while the levels of PLT, FIB, D-D and PAF increased significantly（P 0.05, P 0.01）. Compared with the control group, the level of p50 and p65, TAK1, IκBα in serum increased significantly（P 0.05, P 0.01）, the cytokines（IL-1, TNF-α）,inflammatory and immune indexes（hs-CRP, ESR, Ig G） increased（P 0.05, P 0.01）, but IL-10 reduced significantly（P 0.05） in OA group. Correlation analysis showed that the coagulation related indicators as PLT, FIB, D-D, PAF were positively correlated with p50, p65, TAK1, IL-1, TNF-α, hs-CRP, ESR, Ig G, Lequesne MG, symptom integral meter, and VAS integral, while negatively correlated with IL-10 and each dimension integral of SF-36（P 0.05, P0.01）. However, PT was positively correlated with IL-10, GH and PF, while negatively correlated with p50,p65, TAK1, IL- 1, TNF- α, hs- CRP, ESR, Ig G,symptom integral meter, and VAS integral（P 0.05, P 0.01）. APTT was positively correlated with GH, while negatively correlated with TAK1 and Lequesne MG（P 0.05, P 0.01）; TT was positively correlated with MH, and was negatively correlated with IL-1 and Lequesne MG（P 0.05, P 0.01）. In conclusion, OA patients commonly present a hypercoagulable state in blood, which closely relates with the changes of cytokines and

关 键 词：骨关节炎 高凝状态 NF-ΚB 细胞因子 相关性 

分 类 号：R684.3[医药卫生—骨科学]