血清IL-18与膝骨关节炎关节结构改变相关性研究

The association of serum level of interleukin-18 with structural progression in knee osteoarthritis

目的探讨膝骨关节炎(OA)患者血清白细胞介素(IL)-18水平与关节软骨体积、软骨缺损、骨髓病变(BML)和软骨降解生物标志物之间的横断面相关性,为临床诊治提供新思路和新方法。方法该研究纳入151例膝OA患者,采用问卷调查采集患者一般信息,通过核磁共振成像(MRI)完成膝关节摄片,用OsiriX软件以3D-FLASH序列测量软骨体积,用T2加权序列半定量测定软骨缺损和BML。酶联免疫吸附法(ELISA)检测血清IL-18和基质金属蛋白酶(MMP)-3、MMP-13水平。使用SPSS软件进行统计分析。结果在多变量分析中,血清IL-18水平与总软骨体积呈显著负相关(β=-0.24,95%CI:-0.13~0.03),与不同关节部位的软骨体积(胫骨和髌骨,P<0.05)的相关性一致。血清IL-18水平与股骨内侧的软骨缺损及BML呈正相关(P<0.01)。血清IL-18水平与MMP-3(β=0.31,95%CI:0.001~0.010)和MMP-13(β=0.86,95%CI:0.08~0.10,P<0.01)水平呈正相关。结论血清IL-18水平与膝OA软骨体积呈负相关,与软骨缺损、BML、MMP-3和MMP-13呈正相关,提示IL-18可能在膝OA患者软骨病变中起显著作用,靶向血清IL-18的治疗可能减少膝OA患者关节软骨损伤,延缓疾病进展。

Objective To investigate the cross-sectional associations of serum interleukin(IL)-18 with cartilage volume,cartilage defects,bone marrow lesions(BML)and biomarkers of cartilage degradation in patients with knee osteoarthritis(OA),and to provide new ideas and new methods for clinical diagnosis and treatment.Methods The study included 151 patients with knee OA,a general questionnaire survey was conducted,and the knee structural was photographed by magnetic resonance imaging(MRI).The cartilage volume was measured by OsiriX software in 3D-FLASH sequence,and cartilage defect and BML were determined in T2-weighted sequence.Serum IL-18 and matrix metalloproteinase(MMP)-3,13 levels were measured by enzyme-linked immunosorbent assay(ELISA).SPSS software was used for statistical analysis.Results In multivariable analyses,serum IL-18 level was negatively associated with total cartilage volume(β=-0.24,95%CI:-0.13-0.03)and the association was consistent at divided part of joint(femorotibial joint and the patella femoral joint,all P<0.05).Serum IL-18 level was positively associated with cartilage defect and BML at media femorotibial area(all P<0.01).Serum IL-18 level was positively associated with MMP-3(β=0.31,95%CI:0.001-0.010)and MMP-13(β=0.86,95%CI:0.08-0.10,all P<0.01).Conclusion Serum IL-18 level is negatively associated with cartilage volume and positively associated with cartilage defect,BML,MMP-3 and MMP-13,suggesting IL-18 may play a significant role in the progression of cartilage degradation in patients with knee OA,the therapy of targeting serum IL-18 may reduce the injury of article cartilage in patients with knee OA and delay the progression of disease.