强直性脊柱炎患者外周血中Dickkopf-1和硬骨素的表达及临床意义

Expression and significance of Dickkopf-1 and sclerostin in peripheral blood of patients with ankylosing spondylitis

目的探讨Dickkopf-1(DKK1)与硬骨素在强直性脊柱炎(AS)患者外周血中的表达及临床意义。方法使用酶联免疫吸附法检测40例AS患者和20例年龄、性别相匹配的健康对照者血清中DKK1和硬骨素的表达情况,同时收集AS患者临床资料。结果①AS组血清中DKK1的表达明显高于健康对照组(P<0.05);②使用生物制剂组的AS患者血清中DKK1表达低于未用药组(P<0.05);③DKK1和Bath强直性脊柱炎疾病活动指数(BASDAI)呈正相关(P<0.05,r=0.337);④AS患者血清中硬骨素水平高于健康对照组(P<0.01);⑤早期AS患者硬骨素水平高于晚期AS患者(P<0.05);⑥DKK1和硬骨素之间无相关性。结论DKK1可能参与AS炎症过程;抑制肿瘤坏死因子-α可影响DKK1的表达;硬骨素在AS不同病期表达水平不同;DKK1和硬骨素可能作用于Wnt信号通路的两个独立过程。

Objective To investigate the DKK1 and sclerostin expression and clinical significane in patients with ankylosing spondylitis（AS） in peripheral blood. Methods The levels of DKK1 and sclerostin in sera were measured by enzyme-linked immunosorbent assay in 40 AS patients and 20 age- and sex-matched healthy controls. Meanwhile, the clinical data of patients with AS were collected. Results①The level of DKK1 in AS sera was significantly higher than that in the healthy control group （P 〈 0. 05 ） ;② the level of DKK1 by using anti-TNF-α group was lower than that in the untreated group （ P 〈 0. 05 ） ; ③ DKK1 and BASDAI scores positively correlated （ P 〈 0. 05, r =0. 337） ;④ the level of sclerostin in the sera of AS patients was higher than that in healthy control group （ P 〈 0. 01 ） ; ⑤ the sclerostin level of early AS patients was higher than that of the later AS patients （ P 〈 0. 05 ） ; ⑥ no correlation of DKK1 with sclerostin was found in AS patients. Conclusion DKK1 may be involved in inflammatory process of AS. Inhibition of TNF-α can affect the expression of DKK1, and sclerostin levels were different in the early and later period of AS patients. DKK1 and sclerostin may act in the diferent mechanisms of Wnt signal pathway in AS pathogenesis.