类风湿关节炎患者血清GITRL水平的变化和意义1

Serum level of GITRL in patients with rheumatoid arthritis and their significance

通过检测类风湿关节炎(rheumatoid arthritis,RA)患者血清糖皮质激素诱导型肿瘤坏死因子受体配体(glucocorticoid-induced TNFR-related protein ligand,GITRL)水平,探讨在RA发病中的作用。实验采用双抗体夹心酶联免疫吸附试验(ELISA)测定RA患者(n=27)及健康人(n=23)血清GITRL的水平,分析血清中GITRL的含量与疾病临床表现和其他实验室检查结果之间的关系。结果显示RA患者血清中GITRL为6.08±4.61ng/ml,显著高于健康对照组血清中GITRL(0.38±0.29ng/ml,P<0.001)。进一步分析与RA活动的相关性,发现高疾病活动组(DAS28>5.1)的血清GITRL水平比中低活动组(DAS28<5.1)高两倍,差异具有统计学意义(P<0.05)。根据血清抗CCP抗体和类风湿因子水平分析,发现上述两种抗体阳性者患者血清的GITRL水平明显高于阴性型(P<0.05)。分析RA患者血清GITRL水平与临床和实验室指标的相关性,发现血清GITRL水平与晨僵时间、DAS28、血沉、C-反应蛋白呈正相关。由此我们得出结论RA患者外周血中GITRL水平增高,且与临床常用疾病活动指标呈正相关,提示测定血清GITRL水平具有作为监测RA疾病活动的潜在应用价值。

The ohjective of this study is to assay serum levels of glucocorticoid-induced TNFR-related protein ligand （GITRL） in rheumatoid arthritis（RA） patients and to analyze the relationship between GITRL levels and other laboratory indexes of RA, In this research, serum levels of GITRL were measured in 27 RA patients and 30 health controls using ELISA. Patients were assessed for clinical and laboratory variables. The results indicated that RA patients had significantly increased serum levels of GITRLcompared with controls （6.08±4.61 ng/mlz,s 0.38±0.29 ng/ml, p〈0.001）. After stratified RA patients into high （DAS28〉5. 1） and medium/low disease activity （DAS28〈5.1） subgroups based on RA Disease Activity Score-28 （DAS28）,GITRL levels were about twice-fold higher in patients with high disease activity than those in palients with medium/low disease activity DAS28〈5.1）. When RA patients were classified as seropositive and seronegative subgroups based on the presence of anti-CCP antibody and rheumatoid factor （RF）, seropositive patients conferred significantly higher serum GITRL levels compared to seronegative patients （p〈0.05）. Serum GITRL levels were positively correlated to morning stiffness, DAS28, ESR and CRP in RA patients （p〈0.05）. So we conclude that serum levels of GITRI. are significantly increased in RA patients and are associated with disease activity, suggesting that GITRL might be involved in the pathogenesis of RA.