依那西普对幼年特发性关节炎患儿外周血单核细胞核内核因子-κB表达的影响

Effects of Etanercept on Expression of Nuclear Factor-κB of Monocytes in Peripheral Blood in Children with Juvenile Idiopathic Arthritis

目的观察依那西普对幼年特发性关节炎(JIA)患儿外周血TNFα-水平以及单核细胞核内核因子-κB(NFκ-B)表达的影响,探讨TNFα-和NFκ-B在JIA发病机制中的作用。方法以14例接受依那西普治疗的JIA患儿为观察对象,收集其用药前后的血样标本,采用ELISA法分别测定14例JIA患儿外周血TNFα-水平;并分离其外周血中单核细胞,抽提其核蛋白,采用凝胶迁移试验测定核内NFκ-B水平。结果 1.应用依那西普前NFκ-B水平(31.13±11.76)明显高于应用该药后(21.04±8.53)(t=4.42,P=0.001),TNFα-在治疗前水平[(24.18±7.37)ng·L-1]亦高于依那西普治疗后[(20.21±7.27)ng·L-1](t=2.251,P=0.042);2.NFκ-B水平与TNFα-有良好的相关性(r=0.768,P=0.001),但NFκ-B与单核细胞水平无相关性(r=0.212,P=0.369);3.外周血单核细胞核内NFκ-B与外周血中WBC、单核细胞、PLT、CRP、ESR水平无相关性。结论抗TNF治疗对于JIA患儿有效,依那西普可以下调JIA患儿单核细胞核内NFκ-B水平。NFκ-B和TNFα-在JIA发病机制中可能起一定作用,其水平变化可以作为反映病情活动的指标之一。

Objective To observe effects of etanercept on the expressions of nuclear factor kappa B（NF-κB） of monocytes and tumor necrosis factor-α（TNF-α） in peripheral blood in children with juvenile idiopathic arthritis（JIA） and approach the effects and relationship between NF-κB and TNF-α in JIA pathogenesis.Methods Fourteen JIA children who accepted etanercept were observed,and the samples were collected before they received etanercept treatment and after carried out the anti-TNF drugs therapy.The level of TNF-α in children were measured by enzyme-linked immunosorbent assay.The level of NF-κB in monocytes were detected by electrophoretic mobility shift assay after the monocytes were separated from peripheral blood mononuclear cell.Results 1.The difference of expression of NF-κB in monocytes was significant in statistics between before etanercept treatment and during the etanercept therapy.The level of NF-κB before and during the etanercept treatment were 31.13±11.76 and 21.04±8.53（t=4.42,P=0.001）,and the level of TNF-α in the 2 states were（24.18±7.37） ng·L-1 and（20.21±7.27） ng·L-1（t=2.251,P=0.042）.2.There were correlations between the levels of NF-κB and TNF-α（r=0.768,P=0.001）,but it showed not any correlation between the level of NF-κB and the number of monocytes.3.There were no significant correlations between NF-κB of monocytes in peripheral blood and white blood cell,mononuclear cell platelet,C reactive protein,erythrocyte sedimentation rate in peripheral blood.Conclusions The anti-TNF treatment is effective in JIA children and etanercept can down-regulate the level of NF-κB of monocytes in JIA children.NF-κB and TNF-α may play a role in the pathogenesis of JIA,and their levels may be used as one of the markers for the disease state.