IL-22在类风湿关节炎中的表达及临床意义

Expression and clinical significance of interleukin-22 in patients with rheumatoid arthritis

目的:探讨RA患者IL-22的表达水平并分析其临床意义。方法:流式细胞术检测RA患者(50例)、OA患者(15例)、健康对照组(15例)外周血及RA关节滑液Th22细胞所占比例,ELISA法检测血清及RA关节滑液中IL-22水平。检测RA患者疾病活动性、临床指标、骨破坏情况,分析其与IL-22水平相关性。两组间比较用t检验,相关性分析采用Pearson直线相关分析法,多组样本比较用Kruskal-Wallis H检验。结果:RA患者外周血中Th22细胞比例高于OA组(t=2.290,P=0.021)及健康对照组(t=2.524,P=0.015);RA患者血清IL-22水平高于OA患者(t=2.560,P=0.014)及健康对照组(t=2.768,P=0.009)。RF阳性RA血清IL-22水平高于RF阴性RA(t=2.322,P=0.035)。抗CCP抗体阳性RA血清IL-22水平高于抗CCP抗体阴性RA(t=2.504,P=0.015)。RA血清IL-22水平与ESR、RF、DAS28评分呈正相关关系(r分别为0.312、0.314、0.332,P<0.05)。RA患者血清IL-22水平随骨侵蚀的加重呈递增趋势,X线不同分期之间差异有统计学意义(H=9.14,χ_(0.05(3))~2=7.81,H>χ_(0.05(3))~2,P<0.05)。有关节积液RA患者血清IL-22水平高于无关节积液RA患者(t=2.587,P=0.012),关节滑液IL-22水平高于血清(t=2.668,P=0.011),与关节滑液Th22细胞比例无相关性(r=0.287,P=0.065)。结论:RA患者血清及关节滑液IL-22水平增高,与疾病活动性及骨破坏相关,可成为病情评估与骨破坏的指标。IL-22可能为RA治疗的新靶点。

Objective： To explore the expression of IL-22 in the patients with rheumatoid arthritis,and to define the clinical significance of IL-22 cells for RA. Methods： A total of 50 RA patients,15 OA patients and 15 healthy controls were enrolled. The proportion of Th22 cells in peripheral blood and synovial fluid（ SF） of RA patients was detected by flow cytometry; the levels of IL-22 in serum and synovial fluid of RA patients were detected by ELISA. The clinical parameters of disease activity were assessed including ESR,RF,CRP,DAS28,anti CCP and the degree of bone erosions determined by X-rays. Pearson correlation analysis,t test and Kruskal-Wallis H test were used for statistical analysis. Results： The proportion of Th22 cells in RA patients was higher than that of OA patients（ t= 2. 290,P = 0. 021） and healthy controls（ t = 2. 524,P = 0. 015）. IL-22 levels in RA patients were higher than that of OA patients（ t = 2. 560,P = 0. 014） and healthy controls（ t = 2. 768,P = 0. 009）. IL-22 in the RF positive group were higher than that of RF negative group（ t = 2. 322,P = 0. 035）. IL-22 in the anti-CCP antibody positive group were higher than that of anti-CCP antibody negative group（ t = 2. 504,P = 0. 015）. The levels of IL-22 were correlated positively with ESR,RF,DAS28（ r = 0. 312,0. 314,0. 332,P〈0. 05）. The levels of IL-22 were increased gradually along with the aggravation of bone erosions. There were statistical significant difference among different X-ray stagings（ H = 9. 14,χ_（0.05（3））~2= 7. 81,H χ_（0.05（3））~2,P〈0. 05）. Serum IL-22 levels in the RA patients with joint effusion were higher than that of without（ t = 2. 587,P = 0. 012）. The levels of IL-22 in SF were higher than that in serum（ t =2. 668,P = 0. 011）,and had no correlation with the proportion of Th22 cells in SF. Conclusion： The expression of IL-22 in serum and joint effusion of RA patients increase. The level of IL-22 may be useful marker for assessment of disease activity and finding of bone erosions. Therapeutic targeting of IL-22 may be valuable for the intervention of RA.