强直性脊柱炎患者血清Dkk-1的检测及其临床意义

Clinical Significance of Serum Level of Dkk-1 in Patients with Ankylosing Spondylitis

目的:探讨血清中骨形成抑制因子Dkk-l的表达水平在强直性脊柱炎(AS)中的应用价值。方法:应用酶联免疫吸附法(ELISA)检测应用抗肿瘤坏死因子(TNF)-α类制剂治疗3个月以上以及未用任何抗TNF-α类制剂的疾病活跃期AS患者的血清Dkk-1表达水平。同时对比检测8例未用该剂治疗的疾病活跃期类风湿性关节炎(RA)患者和20例健康对照个体血清Dkk-1的水平。AS患者的病情活跃程度采用AS疾病活动指数(BASDAI)进行评估,RA患者的病情活跃程度采用疾病活动评分(DAS28)进行评估。所有研究对象均测定炎性指标血沉(ESR)和C反应蛋白(CRP)水平。结果:未用药AS患者血清中Dkk-l水平显著低于RA患者和健康对照组(均P<0.01)。AS患者血清Dkk-l水平与BASDAI、ESR和CRP均无明显相关性。使用该剂治疗的AS患者血清Dkk-l水平显著高于未治疗的AS患者(P<0.01)。结论:AS患者血循环中Dkk-1的水平降低,血清Dkk-1的水平与炎症活跃程度无关。抗TNF-α类制剂可诱导AS患者血清Dkk-1的表达。

Objective： To investigate the expression of Dickkopf-l（Dkk-1） and its potential role in patients with anky- losing spondylitis （AS）. Methods： The serum levels of Dkk-1 were measured by sandwich enzyme linked immunosorbent assay （ELISA） in AS patients with treatment of tumor necrosis factor （TNF）ot for more than 3 months and ones without TNF-α treatment. The serum levels of Dkk-1 were also detected in 8 rheumatoid arthritis （RA） patients without TNFα treatment and 20 healthy controls. Bath AS disease activity index （BASDAI） was used to assess the disease activity in patients with AS. And the disease activity score （DAS28） was used in patients with RS. The levels of erythroeyte sedimentation rate （ESR） and C-re- active protein （CRP） were measured in all patients of two groups. Results： The serum level of Dkk-1 was significantly de- creased in AS patients without treatment compared with that of patients with RA （P 〈 0.01） and normal subjects （P 〈 0.05）. There were no correlation between BASDAI, ESR and CRP in patients with AS. The serum level of Dkk-1 was significantly higher in AS patients with treatment than that of AS patients without treatment （P 〈 0.01）. Conclusion： Our results indicated that the serum level of Dkk-1 was lower in AS patients. There were no correlation between the serum level of Dkk and disease activity or markers of inflammation in patients with AS. Furthermore, TNFα could induce the expression of Dkk-i in patients with AS.