强直性脊柱炎中血清高迁移率族蛋白B1和肿瘤坏死因子α的表达与疾病相关性的研究

Elevated serum level of HMGB1 is associated with disease activity and combined alterations with TNF-alpha in ankylosing spondylitis

目的探讨强直性脊柱炎(AS)患者血清高迁移率族蛋白B1(HMGB1)和肿瘤坏死因子α(TNFα)的表达及其与疾病活动的相关性,以寻找治疗AS新靶点。方法本研究纳入50名AS患者,其中30例为初诊未治疗活动期患者,20例为治疗三个月稳定期患者。从同地区选取性别、年龄和种族与疾病组配对的30名正常志愿者作为健康对照。通过ELISA方法测定不同组别的血清HMGB1与TNFα的表达,检测治疗前后与对照组血清HMGB1与TNFα的表达水平,比较分析AS患者HMGB1与TNFα变化以及其与炎性指标、AS躯体功能指数BASFI和AS活动性指数BASDAI之间的相关性。结果 AS患者血清中HMGB1和TNFα水平明显高于正常组,稳定期较活动期患者二者水平明显下降,但仍高于健康对照组;AS患者血清中HMGB1和TNF-α水平均与血沉、超敏C反应蛋白(hsCRP)、BASFI、BASDAI呈正相关;AS患者血清中HMGB1和TNFα水平呈明显的正相关。结论 AS中HMGB1与TNFα的表达升高,与疾病活动性正相关,且两种因子有较强的正相关性,HMGB1在AS的发病中可能扮演了重要角色。

Objective To explore the potential role of HMGB1 in AS and whether serum HMGB1 levels can serve as a biomarker for monitoring response to pharmacotherapy in patients with AS.Methods 50 patients were included in the study,who were devided into two groups.Activity of disease was evaluated according to the Bath AS Disease Activ-ity Index （BASDAI）,and physical functional status of patients was assessed with Bath AS Functional Index （BASFI）. Serum HMGB1 and TNF-alpha levels were determined by commercially available enzyme-linked immunosorbent assay. Markers of inflammation,erythrocyte sedimentation rate （ESR）and high-sensitive C-reactive protein （hs-CRP）levels were measured in all patients.Results The Serum HMGB1 and TNF-alpha levels were significantly increased in AS patients compared to healthy control （HC）,both of them were significantly decreased in inactive AS compared to active AS,but still higher than HC.The serum levels of HMGB1 and TNF-alpha in AS were significant positive correlation with ESR,hsCRP,BASFI and BASDAI.There was significant correlation between HMGB1 levels and TNF-alpha levels in AS patients.Conclusion Our results suggest that HMGB1 might play an important role in the pathogene-sis of AS and HMGB1 and TNF-αmay provide new serum indexes for assessment to AS.