强直性脊柱炎患者Toll样受体4表达和sTRAIL、TNF-α、IL-12水平的研究

Study on the Relationship between Ankylosing Spondylitis and Toll-like Receptor 4,Soluble TNF-related Apoptosis-inducing Ligand

目的探讨Toll样受体(toll-like receptor,TLR)4、可溶性肿瘤坏死因子相关凋亡诱导配体(soluble TNF-related apoptosis-inducing ligand,sTRAIL)、白介素(interleukin,IL)-12、肿瘤坏死因子(tumornecrosis factor,TNF)-α在强直性脊柱炎(ankylosing spondylitis,AS)发病中的作用。方法采用ELISA双抗体夹心法检测110例AS患者和60例正常对照的血清IL-12、TNF-α及sTRAIL水平,并采用逆转录聚合酶链反应(RT-PCR)法检测两组对象外周血单个核细胞TLR4基因水平,同时采用两点终点法测定C反应蛋白(C-reactive protein,CRP)、Wintnobe法检测红细胞沉降率(erythrocyte sedimentation rate,ESR),分析各指标与AS的关联。结果 AS患者TLR4 mRNA表达、血清sTRAIL含量均明显高于正常对照组,差异有统计学意义(P<0.05)。但TNF-α、IL-12与AS发病的相关性无统计学意义(P>0.05)。AS患者组中,血清sTRAIL与CRP(r=0.445,P<0.05)、TNF-α与ESR(r=0.622,P<0.01)均呈正相关。结论 TLR4通路异常及sTRAIL水平增高可能在AS的发病及炎症反应中发挥一定的作用。

Objective To study the effect of toll-like receptor （TLR） 4,soluble tumor necrosis factor-related apoptosis-inducing ligand （sTRAIL）,interleukin （IL）-12,tumor necrosis factor （TNF）-α in pathogenesis of ankylosing spondylitis （AS）. Methods The levels of serum IL-12,TNF-α and sTRAIL were detected by ELISA and the expression of TLR4 mRNA in peripheral blood mononuclear cells （PBMCs） was tested using reverse transcription polymerase chain reaction （RT-PCR） from 110 AS patients and 60 normal controls. C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were determined respectively using two terminal and Wintnobe methods. Results The expression level of TLR4 mRNA in PBMC and serum sTRAIL level were significantly higher in patients with AS than in the normal control （P〈0.05）. However,no significant difference was found on serum TNF-α,IL-12 levels between two groups （P〉0.05）. In AS patients,significant correlation between serum sTRAIL and CRP （r=0.445,P〉0.05） and correlation between serum TNF-α and ESR （r=0.622,P〉0.01） were observed. Conclusion Abnormity of TLR4 pathway and the change of sTRAIL level may play a role in the pathogenesis and inflammatory responses of AS.