IL-1,IL-10及TNF-α在活动性幼年特发性关节炎患者的表达及意义

Clinical Significance and Expression of Serum IL-1,IL-10 and TNF-α 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IL-1、IL-10、TNF-α水平,探讨其与疾病活动、疾病分型以及疾病严重程度的关系。方法:用放射免疫法(RIA)检测IL-1、IL-10、TNF-α水平。结果:30例JIA患者血清中IL-1、TNF-α水平明显高于健康对照组(P<0.001或P<0.01);并与血沉(ESR)、C-反应蛋白(CRP)呈正相关(P<0.001);而与关节肿胀指数、夜间痛及X线分级无关。30例JIA患者血清中IL-10与健康对照组之间相比无统计学意义,并与上述所有观察指标无相关关系。结论:JIA患者血清中IL-1、TNF-α水平显著升高,可能参与了JIA的发病过程,可与ESR、CRP一起作为判断病情活动性的指标,但与疾病严重程度无关,与JIA分型无关。IL-10可能是一种抑炎因子,有抑制关节骨质破坏的作用,针对IL-10的基因及受体治疗可作为控制关节炎症的保护性手段。

Objective：To decteet the soluble forms of interleukin-1 （IL-1）, tumor necrosis factor-α（TNF-α） and interleukin-4 （IL-10） and to study the role of them in juvenile idiopathic arthritis （JIA）. Methods： RIA（radioimmunoassay） technique was used to measure the serum levels of IL-1, IL-10 and TNF-α in 30 patients with the active JIA and 8 normal control subjects. Results：The IL-1, and TNF-α leves in 30 patients with active JIA were significantly higher than those in control subjects （P〈0. 001或0.01）. At the same time, these levels of them had positive correlation with those of ESR,CRP （P〈0. 001）, and had no correlation with joint swelling index, night pain and X radiograph grade. No significant level of IL-10 was found in the active JIA subjects or in the control subjects, and had no correlation with others markers. Conclusion： Patients suffering from JIA showed significant highe serum concentrations of IL-1, TNF-α. These findings suggest the possibility that IL-1, TNF-α participate in the pathogenesis of JIA, and may provide a useful additional marker for disease activity indexes such as ESR and ESR . The level of IL-10 may be a antagonize inflammatory mediation.