类风湿关节炎患者破骨细胞分化情况及其与骨破坏的关系  

Relationship between osteoclast differentiation and bone destruction in patients with rheumatoid arthritis

作　　者：蔡辉[1] 徐子涵[1] 商玮[1] 郭郡浩[1] 赵智明[1] 沈俊逸 CAI Hui;XU Zi-Han;SHANG Wei;GUO Jun-Hao;ZHAO Zhi-Ming;SHEN Jun-Yi(Department of Integrated Traditional Chinese and Western Medicine,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)中西医结合科,南京210002

出　　处：《中国免疫学杂志》2019年第5期604-607,共4页Chinese Journal of Immunology

基　　金：2007年军队系统国家中医药管理局重点专科(专病)建设项目(No.2007ZDZB001)

摘　　要：目的:观察类风湿关节炎(RA)患者破骨细胞(OC)的分化情况,并分析其与RA骨破坏的关系。方法:采用密度梯度离心法分离12例RA患者和10例健康志愿者外周血单个核细胞(PBMC),经核因子κB受体活化因子配体(RANKL)和巨噬细胞集落刺激因子(M-CSF)诱导培养为OC,进行抗酒石酸酸性磷酸酶(TRAP)染色并计数阳性细胞数,分别通过甲苯胺蓝染色及扫描电镜观察骨吸收陷窝;对RA组患者进行Sharp评分及骨密度(BMD)检测,将RA组外周血生成的OC数量与Sharp评分、BMD(T值)进行相关性分析。结果:RA组和对照组生成的OC形态相似; RA组TRAP阳性细胞数(个/10个视野)为127. 67±6. 96,较对照组79. 40±3. 86显著升高(P<0. 05); RA组OC骨吸收功能较对照组明显增强; RA组OC数量与Sharp评分呈显著正相关(r=0. 810,P=0. 001),与BMD(T值)呈显著负相关(r=-0. 685,P=0. 014)。结论:RA患者PBMC向OC分化的能力明显增强,RA患者OC的分化能力与RA骨破坏密切相关。Objective: To observe osteoclast (OC) differentiation in patients with rheumatoid arthritis (RA) and analyze the relationship between osteoclast differentiation and bone destruction in RA. Methods: Peripheral blood mononuclear cells (PBMCs),isolated by density gradient centrifugation from 12 RA patients and 10 healthy volunteers,were cultured into osteoclasts by nuclear factor-κB receptor activating factor ligand (RANKL) and macrophage colony-stimulating factor (M-CSF).Then cells were stained with tartrate-resistant acid phosphatase (TRAP) and the TRAP positive cells were counted.Bone resorption lacunae was observed through toluidine blue staining and scanning electron microscopy.In addition,Sharp scoring and bone mineral density (BMD) detection for RA group patients,which was analyzed with the number of OCs generated by peripheral blood monocytes of RA group patients. Results: The morphology of OCs in RA group and control group was similar.The number of TRAP positive cells in RA group was 127.67±6.96,which was significantly higher than that in control group (79.40±3.86)( P <0.05).The bone absorption function of OCs in RA group was significantly enhanced in comparison with control group.In the RA group,there was a significant positive correlation between the number of OCs and the Sharp score ( r =0.810, P =0.001),and a significant negative correlation with BMD (T value)( r =-0.685, P = 0.014). Conclusion: The ability of PBMCs to differentiate into OCs is obviously enhanced in RA patients,and the differentiation ability of OCs in RA patients is closely related to RA bone destruction.

关 键 词：类风湿关节炎 破骨细胞 外周血单个核细胞 抗酒石酸酸性磷酸酶 骨吸收陷窝 双能X线吸收法 骨密度 

分 类 号：R593.22[医药卫生—内科学]