TNF-α在痛风性关节炎患者炎性反应中的变化及意义
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摘要
目的观察痛风性关节炎患者炎性反应中肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-6(IL-6)、转化生长因子-β(TGF-β)水平的变化,分析与尿酸的相关性。方法回顾性分析2016年1月至2017年12月收治痛风性关节炎患者75例的临床资料,按照痛风性关节炎病情分为急性期痛风性关节炎(AGA) 39例(AGA组),间歇期痛风性关节炎(NAGA) 36例(NAGA组),另选取同期体检的健康人群40例为对照组(CG组);检测各组患者血浆和关节液中TNF-α、IL-1β、IL-6、UA、TGF-β水平,比较各组指标的差异,采用Spearman线性分析各指标的相关性。结果 AGA组、NAGA组血清TNF-α、IL-1β、IL-6、TGF-β、UA水平高于CG组(P <0. 05); AGA组患者TNF-α、IL-1β、IL-6、TGF-β、UA水平高于NAGA组(P <0. 05); AGA组关节液中TNF-α、IL-1β、IL-6、TGF-β、UA水平高于NAGA组(P<0. 05); Spearman相关性分析显示,血清TNF-α水平与IL-1β、IL-6、TGF-β、SUA呈正相关(r=0. 573,0. 862,0. 762,0. 774,P <0. 05); SUA水平与IL-1β、TGF-β、IL-6呈正相关(r=0. 604,0. 805,0. 833,P <0. 05)。结论痛风性关节炎患者机体炎性因子水平明显高于正常人群,血清中TNF-α与尿酸水平呈显著正相关,临床可通过监测炎性因子水平判断疾病严重程度。
Objective To observe the changes of levels of TNF-α,IL-1β,IL-6 and TGF-β in patients with gouty arthritis,and to analyze their correlation with uric acid. Methods The clinical data of 75 patients with gouty arthritis who were admitted and treated in our hospital from January 2016 to December 2017 were retrospectively analyzed. According to the condition of gouty arthritis,there were 39 cases of acute gouty arthritis( AGA group),36 cases of intermittent gouty arthritis( NAGA group),and the other 40 healthy subjects who received physical examination in our hospital at the same period were enrolled as control group. The levels of TNF-α,IL-1β,IL-6,UA and TGF-β in plasma and synovial fluid were detected and compared among the three groups. Moreover the correlation among these indexes was analyzed by Spearman linearity. Results The levels of TNF-α,IL-1β,IL-6,TGF-β,UA in AGA group and NAGA group were significantly higher than those in CG group( P < 0. 05). The levels of IL-6,TGF-β and UA in AGA group were significantly higher than those in NAGA group( P < 0. 05). The levels of TNF-α,IL-1β,IL-6,TGF-β and UA in articular fluid in AGA group w were significantly higher than those in NAGA group( P < 0. 05). Spearman correlation analysis showed that the seum levels of TNF-1β were positively correlated with those of IL-6,TGF-β and SUA( r = 0. 573,0. 862,0. 762,0. 774,respectively,P < 0. 05). Moreover the level of SUA were positively correlated with those of IL-1β,TGF-β and IL-6( r = 0. 604,0. 805,0. 833,respectively,P < 0. 05).Conclusion The serum levels of inflammatory cytokines in patients with gouty arthritis are significantly higher than those in healthy subjects. There is a significant positive correlation between serum levels TNF-α and uric acid levels. To monitor the levels of inflammatory cytokines can evaluate the severity of disease.
Objective To observe the changes of levels of TNF-α,IL-1β,IL-6 and TGF-β in patients with gouty arthritis,and to analyze their correlation with uric acid. Methods The clinical data of 75 patients with gouty arthritis who were admitted and treated in our hospital from January 2016 to December 2017 were retrospectively analyzed. According to the condition of gouty arthritis,there were 39 cases of acute gouty arthritis( AGA group),36 cases of intermittent gouty arthritis( NAGA group),and the other 40 healthy subjects who received physical examination in our hospital at the same period were enrolled as control group. The levels of TNF-α,IL-1β,IL-6,UA and TGF-β in plasma and synovial fluid were detected and compared among the three groups. Moreover the correlation among these indexes was analyzed by Spearman linearity. Results The levels of TNF-α,IL-1β,IL-6,TGF-β,UA in AGA group and NAGA group were significantly higher than those in CG group( P < 0. 05). The levels of IL-6,TGF-β and UA in AGA group were significantly higher than those in NAGA group( P < 0. 05). The levels of TNF-α,IL-1β,IL-6,TGF-β and UA in articular fluid in AGA group w were significantly higher than those in NAGA group( P < 0. 05). Spearman correlation analysis showed that the seum levels of TNF-1β were positively correlated with those of IL-6,TGF-β and SUA( r = 0. 573,0. 862,0. 762,0. 774,respectively,P < 0. 05). Moreover the level of SUA were positively correlated with those of IL-1β,TGF-β and IL-6( r = 0. 604,0. 805,0. 833,respectively,P < 0. 05).Conclusion The serum levels of inflammatory cytokines in patients with gouty arthritis are significantly higher than those in healthy subjects. There is a significant positive correlation between serum levels TNF-α and uric acid levels. To monitor the levels of inflammatory cytokines can evaluate the severity of disease.
引文
1邹晋梅,杨静,董建玲,等.血清及关节液中炎症细胞因子在老年急性痛风性关节炎中的变化及其意义.中国老年学杂志,2016,36:5420-5422.
2 Han Q,Bing W,Di Y,et al.Kinsenoside screening with a microfluidic chip attenuates gouty arthritis through inactivating NF-κB signaling in macrophages and protecting endothelial cells.Cell Death&Disease,2016,7:567-569.
3 Jhang JJ,Lu CC,Yen GC.Epigallocatechin gallate inhibits urate crystalsinduced peritoneal inflammation in C57BL/6 mice.Molecular Nutrition&Food Research,2016,60:2297-2303.
4 Neogi T,Jansen TL,Dalbeth N,et al.2015 Gout classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis&Rheumatology,2015,67:2557-2568.
5 Dhanasekar C,Kalaiselvan S,Rasool M.Morin,a bioflavonoid suppresses monosodium urate crystal-induced inflammatory immune response in RAW264.7 macrophages through the inhibition of inflammatory mediators,Intracellular ROS levels and NF-κB activation.Plo S One,2015,10:564-569.
6 Liu Y,Zhao Q,Yin Y,et al.Serum levels of IL-17 are elevated in patients with acute gouty arthritis.Biochem Biophys Res Commun,2018,497:897-902.
7 Wang CL,Yang JZ.Treatment of gouty arthritis of the first metatarsophalangeal joint by Masquelet technique.Zhongguo Gu Shang,2017,30:763-766.
8兰宇斌,周红星.痛风性关节炎患者血清中嘌呤能受体和痛风相关炎症因子水平的表达及相关性研究.中国卫生工程学,2017,16:524-528.
9曾学军.《2010年中国痛风临床诊治指南》解毒.中国实用内科杂志,2012,32:438-441.
10杨虹,杨小红,钟晓武,等.辅助性T细胞17/调节性T细胞平衡在原发性痛风性关节炎发病机制中的作用.中华风湿病学杂志,2016,20:520-525.
11 Gamala M,Linn-Rasker SP,Nix M,et al.Gouty arthritis:decisionmaking following dual-energy CT scan in clinical practice,a retrospective analysis.Clin Rheumatol,2018,37:1879-1884.
12 CHu YL,Jiang YQ,Sun SL,et al.The differential profiles of long noncoding RNAs between rheumatoid arthritis and gouty arthritis.Discov Med,2017,24:133-146.
13 Zhang QB,Qing YF,He YL,et al.Association of NLRP3 polymorphisms with susceptibility to primary gouty arthritis in a Chinese Han population.Clin Rheumatol,2018,37:235-244.
14 Liu SM,Zhang N,Yu DH,et al.Liver metabonomics of acute gouty arthritis treated by Diosocorea nipponica.Zhongguo Zhong Yao Za Zhi,2017,42:1971-1978.
15邹晋梅,杨静,董建玲,等.血清及关节液中炎症细胞因子在老年急性痛风性关节炎中的变化及其意义.中国老年学杂志,2016,36:5420-5421.
16杨虹,杨小红,青玉凤,等.固有免疫和适应性免疫在痛风性关节炎发病机制中的研究进展.中华风湿病学杂志,2016,20:415-417.
17刘淑娟,丁焕发,徐晓辰,等.急性痛风性关节炎患者血清IL-1β、IL-6、IL-18及TNF-α水平的研究.中国医药指南,2016,14:3-5.
18党万太,王婧,谢文光,等.s CD14在痛风性关节炎患者炎症反应中的变化及其意义.西安交通大学学报(医学版),2015,36:514-518.
19白燈佳.痛风性关节炎患者血清及组织中IL-17水平研究.北京协和医学院,2015.
20黄继勇,张艳.痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化.中华全科医学,2017,15:1487-1489.
2 Han Q,Bing W,Di Y,et al.Kinsenoside screening with a microfluidic chip attenuates gouty arthritis through inactivating NF-κB signaling in macrophages and protecting endothelial cells.Cell Death&Disease,2016,7:567-569.
3 Jhang JJ,Lu CC,Yen GC.Epigallocatechin gallate inhibits urate crystalsinduced peritoneal inflammation in C57BL/6 mice.Molecular Nutrition&Food Research,2016,60:2297-2303.
4 Neogi T,Jansen TL,Dalbeth N,et al.2015 Gout classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative.Arthritis&Rheumatology,2015,67:2557-2568.
5 Dhanasekar C,Kalaiselvan S,Rasool M.Morin,a bioflavonoid suppresses monosodium urate crystal-induced inflammatory immune response in RAW264.7 macrophages through the inhibition of inflammatory mediators,Intracellular ROS levels and NF-κB activation.Plo S One,2015,10:564-569.
6 Liu Y,Zhao Q,Yin Y,et al.Serum levels of IL-17 are elevated in patients with acute gouty arthritis.Biochem Biophys Res Commun,2018,497:897-902.
7 Wang CL,Yang JZ.Treatment of gouty arthritis of the first metatarsophalangeal joint by Masquelet technique.Zhongguo Gu Shang,2017,30:763-766.
8兰宇斌,周红星.痛风性关节炎患者血清中嘌呤能受体和痛风相关炎症因子水平的表达及相关性研究.中国卫生工程学,2017,16:524-528.
9曾学军.《2010年中国痛风临床诊治指南》解毒.中国实用内科杂志,2012,32:438-441.
10杨虹,杨小红,钟晓武,等.辅助性T细胞17/调节性T细胞平衡在原发性痛风性关节炎发病机制中的作用.中华风湿病学杂志,2016,20:520-525.
11 Gamala M,Linn-Rasker SP,Nix M,et al.Gouty arthritis:decisionmaking following dual-energy CT scan in clinical practice,a retrospective analysis.Clin Rheumatol,2018,37:1879-1884.
12 CHu YL,Jiang YQ,Sun SL,et al.The differential profiles of long noncoding RNAs between rheumatoid arthritis and gouty arthritis.Discov Med,2017,24:133-146.
13 Zhang QB,Qing YF,He YL,et al.Association of NLRP3 polymorphisms with susceptibility to primary gouty arthritis in a Chinese Han population.Clin Rheumatol,2018,37:235-244.
14 Liu SM,Zhang N,Yu DH,et al.Liver metabonomics of acute gouty arthritis treated by Diosocorea nipponica.Zhongguo Zhong Yao Za Zhi,2017,42:1971-1978.
15邹晋梅,杨静,董建玲,等.血清及关节液中炎症细胞因子在老年急性痛风性关节炎中的变化及其意义.中国老年学杂志,2016,36:5420-5421.
16杨虹,杨小红,青玉凤,等.固有免疫和适应性免疫在痛风性关节炎发病机制中的研究进展.中华风湿病学杂志,2016,20:415-417.
17刘淑娟,丁焕发,徐晓辰,等.急性痛风性关节炎患者血清IL-1β、IL-6、IL-18及TNF-α水平的研究.中国医药指南,2016,14:3-5.
18党万太,王婧,谢文光,等.s CD14在痛风性关节炎患者炎症反应中的变化及其意义.西安交通大学学报(医学版),2015,36:514-518.
19白燈佳.痛风性关节炎患者血清及组织中IL-17水平研究.北京协和医学院,2015.
20黄继勇,张艳.痛风患者外周血中炎症因子IL-18、IL-1β、TNF-α的变化.中华全科医学,2017,15:1487-1489.