伴有关节外表现的强直性脊柱炎患者血中sCD40L和几种细胞因子的变化

Changes of sCD40L and several kinds of cytokines in ankylosing spondylitis patients with extra-articular manifestation

目的: 探讨不同病情状态下,强直性脊柱炎(AS)患者血中几种细胞因子的变化及意义。方法:除常规指标检测外,可溶性CD40配体(sCD40L)和几种细胞因子的检测采用放免分析法完成。结果:sCD40L在疾病活动组及伴关节外表现组明显升高,且与几种细胞因子的增加呈正相关;sIL 2R、IL 6、TNF- α在疾病活动组及伴关节外表现组均增高;可溶性血管细胞黏附分子 1(sVCAM -1)仅在伴关节外表现组明显升高;sCD40L与免疫球蛋白的增加正相关与补体C3 的下降负相关。结论:sCD40L是反映AS患者体内免疫机能异常状态的重要指标;sIL 2R、IL -6、TNFα在AS疾病发生发展过程中具有重要意义;sVACM- 1在免疫复合物损伤,血管炎性病变的发生上具有直接作用,可做为AS伴关节外表现出现的监测指标。

Objective: To investigate changes and significance of several kinds of cytokines in ankylosing spondylitis (AS) patients with different conditions. Methods: Besides routine detection, soluble CD40 ligand (sCD40L) and several kinds of cytokines were measured by using radioimmunoassay. Results: The sCD40L increased obviously in the group with active disease and the group with extra-articular manifestation. The increase of sCD40L was positivey relevant with the increase of the cytokines. The sIL-2R, IL-6 and TNF-α increased in both the group with active disease and the group with extra-articular manifestation while vascular cell adhesion molecule-1 (sVCAM-1) only increased in the latter. The sCD40L was positively related to immunoglobulin but negatively to C 3. Conclusion: The sCD40L is an important index in evaluating the abnormal immune state in AS patients. The sIL-2R, IL-6, and TNF-α are important in the process of AS. The sVCAM-1 plays a direct role in the immune complex injury and the vasculitis onset, and it can act as a surveillance index in AS patients with extra-articular manifestation.