活动性幼年特发性关节炎患者sICAM-1 sVCAM-1的表达及意义

Clinical significance and expression of serum intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 in patients with active juvenile idiopathic arthritis

目的测定各型活动性幼年特发性关节炎(JIA)患儿血清中可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管间黏附分子-1(sVCAM-1)、白细胞介素(IL)-1、IL-4、肿瘤坏死因子(TNF)-α水平,探讨sICAM-1、sVCAM-1与疾病活动、疾病分型以及疾病严重程度的关系。方法用酶联免疫吸附试验(ELISA)检测30例活动性JIA患儿与8名健康对照儿童sICAM-1、sVCAM-1水平;用放射免疫法(RIA)检测IL-1、IL-4、TNF-α水平。结果30例JIA患者血清中sICAM-1、sVCAM-1、IL-1、IL-4、TNF-α水平明显高于健康对照组(P<0.01);在各型JIA中sVCAM-1与血沉(ESR)、C反应蛋白(CRP)呈正相关(P<0.05或0.01);而sICAM-1仅在全身型及多关节型JIA患儿中与关节肿胀指数、夜间痛呈正相关(P<0.01),与炎性指标ESR、CRP等无关。结论JIA患者血清中sICAM-1、sVCAM-1、IL-1、IL-4、TNF-α水平显著升高,可能参与了JIA的发病过程,sVCAM-1、sICAM-1可与ESR、CRP一起作为判断病情严重性的指标,且可能与JIA分型有关。

Objective The soluble forms of intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) were detected. Moreover, the role of sICAM-1 and sVCAM-1 in juvenile idiopathic arthritis (JIA) were studied. Methods ELISA and radioimmunoassay (RIA) technique were used to measure the serums levels of sICAM-1, sVCAM-1 and IL-1, IL-4, TNF-α in 30 patients with active JIA and 8 normal control subjects. Results The levels of sICAM-1, sVCAM-1 and IL-1, IL-4, TNF-α in 30 patients with active JIA were significantly higher than those of control subjects (P<0.01). At the same time, the level of sICAM-1 was positively correlated with ESR and CRP (P<0.05 or 0.01). Only in systemic and polyarthritis JIA the level of sVCAM-1 had positive correlation with joint swelling index, night pain (P<0.01), but no correlation with other markers. Conclusion Patients suffered from JIA showes significantly higher serum concentrations of sICAM-1, sVCAM-1 and IL-1, IL-4, TNF-α. These findings suggest the possibility that sICAM-1, sVCAM-1 has participated in the pathogenesis of JIA. The level of sICAM-1 may provide a useful marker for disease activity. The level of sVCAM-1 may be expected to be used in evaluating disease status and may be associated with the categories of JIA.