类风湿关节炎患者滑膜、滑液和血浆中PAI的检测及其临床意义

Detection and significance of plasminogen activator inhibitor in synovial tissue,synovial fluid and plasma from patients with rheumatoid arthritis

目的 检测Ⅰ型和Ⅱ型纤溶酶原激活物抑制剂 (PAI 1和PAI 2 )在类风湿关节炎 (RA)患者滑膜组织中的定位和表达 ,同时测定RA患者滑液和血浆中PAI 1的含量和活性 ,并分析其临床意义。方法 运用免疫组织化学方法检测了 2 4例RA、18例骨关节炎 (OA)和 6例正常滑膜组织中PAI 1和PAI 2的定位及其表达 ;采用ELISA双抗体夹心法测定 46例RA和 8例OA患者血浆、14例RA滑液和 12例正常对照血浆中PAI 1的含量和活性。结果 2 4例RA滑膜组织 ,全部呈PAI 1阳性染色 ,8例呈PAI 2阳性染色 ,阳性细胞主要定位在滑膜衬里层 ;18例OA中 ,9例呈PAI 1阳性染色 ,阳性细胞分布部位类似于RA ,未检出PAI 2阳性信号 ;6例正常滑膜组织中均未检测到PAI 1和PAI 2阳性染色。RA患者滑液中PAI 1的含量和活性显著高于其自身血浆 (P <0 0 0 1和P <0 0 5 ) ;而RA患者血浆中PAI 1的含量及活性亦明显高于OA组 (P <0 0 5 ,P <0 0 0 0 1)和正常对照组 (P <0 0 0 0 1,P <0 0 0 1) ;并且RA患者滑液和血浆中PAI 1的含量和活性与RA患者病情活动指标呈正相关。结论 PAI 1和PAI 2在RA滑膜组织中表达增高 ,其中PAI 1增高更显著 ,PAI 1在RA滑液和血浆中的含量和活性均明显高于OA和正常对照组 ,且与RA病情密切相关 ,说明PAI、尤其是PAI 1在RA的发?

Objective To study the distribution and expression of type-1 plasminogen activator inhibitor( PAI-1) and type-2 plasminogen activator inhibitor (PAI-2) in synovial tissue from rheumatoid arthritis(RA) and measure the antigen levels and activity in synovial fluid and plasma of patients with RA. Methods Immuno-histochemical analysis was used to detect PAI-1 and PAI-2 expression and distribution in synovial tissue from 24 RA patients, 18 osteoarthritis (OA) patients and 6 normal subjects. PAI-1 and PAI-2 antigen concentration and activity were determined with ELISA sandwich method. Results In RA patients, positive staining of PAI-1 and PAI-2 was seen respectively in all the 24 cases and 8 of the 24cases; positive expression was distributed mainly in the synovial lining area. In OA patients, positive staining of PAI-1 was detected in 8 cases and its positive distribution was similar to that in RA. No PAI-2 positive staining was seen in all the OA cases. In 6 normal subjects with normal synovial tissue,the staining was negative. The concentration and activity of PAI-1 in RA synovial fluid(SF) were significantly higher than those in the plasma(P<0.001and P<0.05). The concentration and activity of PAI-1 in the plasma of RA were also much higher than those in the plasma of OA(P<0.05 and P<0.000 1)and healthy subjects(P<0.000 1and P<0.001). The concentration and activity of PAI-1 in SF and plasma of RA correlated positively. Conclusion The up-regulated expression of PAI-1 and PAI-2 and the concentration and activity of PAI-1 in SF and plasma were significantly higher in RA than those in OA and healthy subjects, suggesting PAI especially PAI-1 may play an important role in the pathogenesis of RA.