血管内皮生长因子在脊柱关节病外周关节病变发病机制中的作用研究  

Study of the role of vascular endothelial growth factor in the pathogenesis of spondyloarthropathy patients

作　　者：赵绵松[1] 黄烽[1] 朱剑[1] 徐明[1] 丁玉珍[1] 

机构地区：[1]解放军总医院风湿科,北京100853

出　　处：《中华风湿病学杂志》2004年第5期262-265,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金委杰出青年科学基金资助项目(30025041);国家自然科学基金资助面上项目(30271233)

摘　　要：目的探讨血管内皮生长因子(VEGF)在脊柱关节病(SpA)发病机制中的作用以及与疾病活动性的相关性。方法收集外周血单个核细胞(PBMC)和关节液中的单个核细胞(SFMC),经脂多糖(LPS)刺激后,采用反转录聚合酶链反应(RT-PCR)检测VEGFmRNA的表达,并与疾病活动性进行相关性比较,同时采用酶联免疫吸附试验(ELISA)方法测定关节液和血清中的VEGF(SF-VEGF/s-VEGF),并与VEGFmRNA以及疾病活动性进行相关性比较。结果未经任何刺激的PBMC无VEGFmRNA表达,经LPS刺激的SFMC其VEGFmRNA的表达比未经刺激的SFMC显著增高,未经刺激的SFMCVEGFmRNA表达与临床常用的疾病活动性指标C反应蛋白(CRP)显著相关,经LPS刺激后的SFMCVEGFmRNA表达还与Bath强直性脊柱炎(AS)疾病活动性指数(BASDAI)、外周关节肿胀数、SF-VEGF、s-VEGF显著相关。SF-VEGF水平较s-VEGF明显增高,SF-VEGF水平与BASDAI、外周关节肿胀数以及外周血白细胞计数的相关有显著性;s-VEGF水平显示出与BASDAI、Bath强直性脊柱炎功能指数(BASFI)、外周关节肿胀数、疲倦程度以及外周血小板计数有相关性。结论SpA患者SFMC表达VEGFmRNA,LPS可上调其表达;SF-VEGF水平高于s-VEGF,与血沉(ESR)、CRP相比s-VEGF更能准确反应机体疾病活动性。Objective To determine the expression of vascular endothelial growth factor (VEGF) in synovial fluid mononuclear cell (SFMC)/ peripheral blood mononuclear cells (PBMC) and understand its potential significance in the pathogenesis of spondyloarthropathy(SpA).Methods SFMC was isolated from patie-nts'synovial fluid(SF) and was stimulated by LPS.The expression of VEGF mRNA was determined by reverse tr-anscription polymerase chain reaction (RT-PCR).Paired samples of PBMC were obtained from 24 SpA patients.The levels of VEGF in serum and SF were measured using enzyme linked immunosorbent assay (ELISA).Sera were collected from 20 ankylosing spondylitis(AS) patients,24 SpA patients and 20 normal controls.Corresponding SF concentration of VEGF were tested in 24 SpA patients.The correlation between VEGF levels/VEGF mRNA and clinical and laboratory parameters was analysed respectively.Result LPS activated SFMC resulted in high expression in VEGF.The concentration of SF-VEGF and s-VEGF in 24 SpA patients with active disease was significantly higher than inactive AS patients and healthy controls.The concentration of serum VEGF and SF-VEGF displayed a significant correlation with a number of clinical and laboratory parameters of disease activity.The concentration of SFVEGF was significantly higher than those detected in corresponding sera.Moreover,a clear correlation was found between corresponding SF and serum VEGF concentration.Conclusion VEGF expression in SFMC within SpA inflamed peripheral joints appears to be regulated by LPS.SF-VEGF is significantly higher than s-VEGF.These data indicate that s-VEGF may be potential useful new markers of SpA disease activities.

关 键 词：血管内皮生长因子 脊柱关节病 外周关节病 VEGF SPA 发病机制 临床表现 

分 类 号：R593.23[医药卫生—内科学]