血清MMP-3、TIMP-1与单核细胞CD147在湿热痹阻及寒湿痹阻型类风湿关节炎中的意义

Significance of Serum MMP-3, TIMP-1, and Monocyte CD147 in Rheumatoid Arthritis Patients of Damp-heat Bi-syndrome and of Cold-damp Bi-syndrome

目的探讨血清基质金属蛋白酶-3(MMP-3)、金属蛋白酶抑制剂-1(TIMP-1)与单核细胞CD147分子在湿热痹阻及寒湿痹阻型类风湿关节炎(RA)中的意义。方法收集22例住院和门诊RA患者的临床数据及外周血,进行28个关节疾病活动度评分[DAS28(4)],双抗体夹心酶联免疫吸附试验(ELISA)检测血清MMP-3及TIMP-1水平,流式细胞术检测单核细胞表面CD147的平均荧光强度及表达的百分率,分析各指标在湿热痹阻型与寒湿痹阻型RA间的差异。结果湿热痹阻型RA血清MMP-3水平、单核细胞表面CD147平均荧光强度显著高于寒湿痹阻型RA组与正常对照组(P<0.05)。湿热痹阻型RA血清TIMP-1水平明显高于正常对照组(P<0.05),而两中医证型组间差异无统计学意义。湿热痹阻型RA患者单核细胞CD147的表达率显著低于寒湿痹阻型RA组与正常对照组(P<0.05)。结论湿热痹阻型RA血清高水平的MMP-3可能会导致关节软骨及骨质的破坏,其单核细胞CD147平均荧光强度的增高与表达率的下降可能是RA疾病活动度增高,单核细胞迁移入滑膜组织的结果。

Objective To explore the clinical significance of serum matrix metalloproteinase-3 （ MMP- 3）, tissue inhibitor of metalloproteinase- 1 （TIMP- 1 ）, and monocyte CD147 in rheumatoid arthritis （RA） patients of damp-heat Bi-syndrome （DHBS） and of cold-damp Bi-syndrome （CDBS）. Methods The clinical data of 22 patients from inpatients and outpatients with RA were collected, and their peripher- al blood was withdrawal. The disease activity scores [ DAS28 （4） ] were assessed. The serum levels of MMP-3 and TIMP-1 were detected by double antibody sandwich enzyme linked immunosorbent assay （ELISA）. The mean fluorescence intensity （MFI） and the expression percentage of CD147 on CD14 ＋ mono- cytes were detected by flow cytometry. The difference of each index between RA patients of DHBS and RA patients of CDBS was analyzed. Results The level of serum MMP-3 and the MFI of CD147 on the monocyte surface were obviously higher in RA patients of DHBS than in those of CDBS and the normal control group （P 〈0.05）. The concentration of serum TIMP- 1 was obviously higher in RA patients of DH- BS than in those of the normal control group （ P 〈0.05）, while there was no statistical difference between the two syndrome types. The percentage of CD147 expression was obviously lower in DHBS than in those of CDBS and the normal control group （ P 〈0.05）. Conclusions Increased serum MMP-3 level of RA pa- tients of DHBS might result in destroy of joint cartilages and sclerotin. The significant increase of MFI and decreased expression percentage of monocyte CD147 might be the results of increased disease activity of RA and monocyte migration to the synoviat membrane tissue.