类风湿关节炎患者Th17细胞膜上RANKL的表达及意义

RANKL expression on Th17 cells in rheumatoid arthritis and its significance to clinic

目的探讨类风湿关节炎(rheumatoid arthritis,RA)患者外周血和关节液中Th17细胞膜上RANKL的表达水平与RA病情活动程度指标CRP、ESR、RF及DAS28评分的关系。方法用流式细胞术及RT-PCR方法检测RA患者外周血和关节液中Th17细胞膜上RANKL的表达水平。结果 RA患者外周血Th17细胞膜上RANKL表达明显高于健康对照组(P<0.05),RA患者关节液中Th17细胞膜上RANKL表达高于RA外周血(P<0.05),RA患者外周血Th17细胞膜上RANKL表达与DAS28评分呈正相关性(r=0.36,P<0.05)。RTPCR结果提示RA患者CD4^+T上RANKL表达较健康对照组升高(P<0.05)。CD4^+T细胞RANKL mRNA水平与IL-17mRNA水平呈显著正相关(r=0.63,P<0.001)。结论 Th17细胞膜上RANKL表达明显升高,且与病情活动程度显著相关,提示Th17细胞可能参与RA骨破坏过程,在RA的破骨免疫致病机制中可能起重要作用。

Objective To study the expression of blood and synovial fluid RANKL on Thl7 cells in patient with rheumatoid arthritis by analyzing the correlations between their expression level and the indexes reflecting RA disease and to elaborate the relationship between Th17 cells and bone destruction.Methods Expression of RANKL on Th17 cells from RA and control group was evaluated by flow cytometry and RT-PCR.Results Expression of RANKL on Th17 cells was higher in RA blood than that in control group（P0.05）,and it was higher in RA synovial fluid（P0.05）.There was a significantly positive correlation between expression of RANKL on Th17 cells in peripheral blood of RA and DAS28（r = 0.36,P0.05）.Results from RT-PCR indicated that RANKL on CD4~＋ T cells was higher than that in control group（P0.05）.A positive correlation was also found between RANKL mRNA and IL-17 mRNA on CD4~＋ T cell.Conclusion RANKL on Th17 cells overexpresses in RA blood and synovial fluid,and has a significantly positive correlation with DAS28 in RA patients. Th17 cells may be involved in the process of RA bone destruction,and may play an important role in RA immune pathogenesis of osteoclasts.