强直性脊柱炎患者血清MMP-9、DKK-1水平与疾病活动度的关系

Relationship between serum levels of MMP-9 and DKK-1 and disease activity in patients with ankylosing spondylitis

目的探讨强直性脊柱炎(AS)患者血清基质金属蛋白酶-9(MMP-9)、Dickopff相关蛋白-1(DKK-1)水平与疾病活动度的关系。方法将该院风湿免疫科接诊的145例AS患者纳入AS组,并根据疾病活动指数(BASDAI)评分,分为非活动期组(<4分)48例、活动期组(≥4分)97例,给予肿瘤坏死因子-α(TNF-α)拮抗剂治疗24周;另选取年龄、性别相匹配的健康体检者62例为对照组;测定血沉(ESR)、C反应蛋白(CRP)、MMP-9、DKK-1水平和疾病活动度[BASDAI、AS功能指数(BASFI)、AS病情活动度评分(ASDAS)],并分析DKK-1、MMP-9与BASDAI、BASFI、ASDAS评分的关系。结果 AS组ESR和血清CRP、MMP-9水平均高于对照组(P<0.05),血清DKK-1水平低于对照组(P<0.05);活动期组血清DKK-1低于非活动期组(P<0.05),血清MMP-9水平高于非活动期组(P<0.05);AS患者治疗后血清DKK-1、AS脊柱评分(mSASSS)评分均无明显变化(P>0.05),MMP-9和BASDAI、BASFI、ASDAS评分均明显下降(P<0.05);相关性分析显示,DKK-1与BASDAI、BASFI、ASDAS评分无明显相关性(P>0.05);MMP-9与BASFI评分不相关(P>0.05),与BASDAI、ASDAS评分呈正相关(P<0.05)。结论 AS患者血清DKK-1呈低表达,MMP-9呈高表达,TNF-α拮抗剂能明显下调MMP-9水平,对DKK-1无明显影响,MMP-9可反映AS的疾病活动度,DKK-1与疾病活动度无明显相关。

Objective To explore the relationship between serum levels matrix metalloproteinase-9(MMP-9)and Dickopff-related protein-1(DKK-1)and disease activity in patients with ankylosing spondylitis(AS).Methods 145 cases of patients with AS admitted to rheumatology and immunology department of our hospital were included in AS group.According to the disease activity index Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)score,they were divided into inactive phase group(<4 points,48 cases)and active phase group(≥4 points,97 cases).The two group were treated with antagonist of tumor necrosis factor-α(TNF-α)for 24 weeks.Another 62 healthy examiners with matched age and gender were selected as control group.The levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),MMP-9 and DKK-1 and disease activity(BASDAI,BASFI,ASDAS)were measured,and the relationship between DKK-1,MMP-9 and BASDAI,BASFI,ASDAS scores were analyzed.Results The levels of ESR and serum CRP and MMP-9 in AS group were higher than those in control group(P<0.05)while serum DKK-1 level was lower than that in control group(P<0.05).Serum DKK-1 level in active phase group was lower than that in inactive phase group(P<0.05)while serum MMP-9 level was higher than that in inactive phase group(P<0.05).There was no significant change in serum DKK-1 level,mSASSS score after treatment in AS patients(P>0.05),and the MMP-9 level and scores of BASDAI,BASFI and ASDAS were significantly decreased(P<0.05).Correlation analysis showed that there was no significant correlation between DKK-1 and BASDAI,BASFI,ASDAS scores(P>0.05).MMP-9 was not correlated with BASFI score(P>0.05),and was positively correlated with BASDAI and ASDAS scores(P<0.05).Conclusion Serum DKK-1 is lowly expressed in AS patients,and MMP-9 is highly expressed.TNF-αantagonist can significantly down-regulate MMP-9 level,but has no significant effects on DKK-1.MMP-9 can reflect the disease activity of AS,and DKK-1 is not significantly corrected with disease activity.