類風濕關節炎患者血清和關節液白細胞介素-17A與疾病活動的關系_《華西醫學》

作者：

林輝 ¹ , 陳永濤 ¹ , 周燕莉 ² ,  劉毅 ¹

1 四川大學華西醫院風濕免疫科（成都，610041）;2 瀘州醫學院風濕科;

關鍵詞：

類風濕關節炎血清關節液白細胞介素17A

DOI：

10.7507/1002-0179.20130482

視頻：

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目的　檢測類風濕關節炎（RA）患者血清和關節液白細胞介素17A（IL-17A）的變化，探討其與臨床炎癥指標、疾病活動性的關系。方法　2011年6月－2012年6月采用酶聯免疫吸附試驗檢測30例活動性RA患者和20例健康對照血清IL-17A水平，其中18例有膝關節積液RA患者同時檢測配對血清和關節液IL-17A水平。結果　RA組患者血清IL-17A水平顯著高于健康對照組[（40.651 ± 16.402）、（23.799 ± 10.693） pg/mL，P＜0.05]。RA患者關節液IL-17A水平明顯高于其血清中水平[（63.555 ± 23.405）、（43.727 ± 17.212） pg/mL，P＜0.05]。RA患者血清IL-17A水平只與疾病活動性評分（DAS28）呈正相關（r=0.498，P=0.020），而RA患者關節液IL-17A水平與DAS28和血清C反應蛋白有相關性（r=0.515，P=0.029；r=0.498，P=0.035）。結論　RA患者血清和關節液IL-17A水平與疾病活動性顯著相關，提示IL-17A可作為衡量疾病活動和關節損傷的標志之一。

引用本文： 林輝,陳永濤,周燕莉,劉毅. 類風濕關節炎患者血清和關節液白細胞介素-17A與疾病活動的關系. 華西醫學, 2013, 28(10): 1521-1524. doi: 10.7507/1002-0179.20130482 復制

1.	Imboden JB. The immunopathogenesis of rheumatoid arthritis[J]. Annu Rev Pathol, 2009, 4: 417-434.
2.	Korn T, Bettelli E, Oukka M, et al. IL-17 and Th17 cells[J]. Annu Rev Immunol, 2009, 27: 485-517.
3.	Nakae S, Nambu A, Sudo K, et al. Suppression of immune induction of collagen-induced arthritis in IL-17-deficient mice[J]. J Immunol, 2003, 171(11): 6173-6177.
4.	Lubberts E, Koenders MI, Oppers-Walgreen B, et al. Treatment with a neutralizing anti-murine interleukin-17 antibody after the onset of collagen-induced arthritis reduces joint inflammation, cartilage destruction, and bone erosion[J]. Arthritis Rheum, 2004, 50(2): 650-659.
5.	Sarkar S, Fox DA. Targeting IL-17 and Th17 cells in rheumatoid arthritis[J]. Rheum Dis Clin North Am, 2010, 36(2): 345-366.
6.	Melis L, Vandooren B, Kruithof E, et al. Systemic levels of IL-23 are strongly associated with disease activity in rheumatoid arthritis but not spondyloarthritis[J]. Ann Rheum Dis, 2010, 69(3): 618-623.
7.	Hitchon CA, Alex P, Erdile LB, et al. A distinct multicytokine profile is associated with anti-cyclical citrullinated peptide antibodies in patients with early untreated inflammatory arthritis[J]. J Rheumatol, 2004, 31(12): 2336-2346.
8.	Mika K, Akito T, Hiroto M, et al. Interleukin-17 gene expression in patients with rheumatoid arthritis[J]. Mod Rheumatol, 2008, 18(1): 15-22.
9.	Yamada H, Nakashima Y, Okazaki K, et al. Th1 but not Th17 cells predominate in the joints of patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2008, 67(9): 1299-1304.
10.	Cho ML, Yoon CH, Hwang SY, et al. Effector function of typeⅡ collagen-stimulated T cells from rheumatoid arthritis patients: cross-talk between T cells and synovial fibroblasts[J]. Arthritis Rheum, 2004, 50(3): 776-784.
11.	Zhu JF, Yamane H, Paul WE. Differentiation of effector CD4 T cell populations[J]. Annu Rev Immunol, 2010, 28: 445-489.
12.	盧月, 曹雅晶, 錢瑞琴. IL-17在類風濕關節炎發病機制中的作用[J]. 中國免疫學雜志, 2011, 27(9): 855-859.
13.	Hwang SY, Kim JY, Kim KW, et al. IL-17 induces production of IL-6 and IL-8 in rheumatoid arthritis synovial fibroblasts via NF-kappaB- and PI3-kinase/Akt-dependent pathways[J]. Arthritis Res Ther, 2004, 6(2): 120-128.
14.	Moran EM, Connolly M, Gao W, et al. Interleukin-17a induction of angiogenesis, cell migration, and cytoskeletal rearrangement[J]. Arthritis Rheum, 2011, 63(11): 3263-3273.
15.	Shahrara S, Pickens SR, Mandelin AM, et al. IL-17-mediated monocyte migration occurs partially through CC chemokine ligand 2/monocyte chemoattractant protein-1 induction[J]. J Immunol, 2010, 184(8): 4479-4487.
16.	Van HJ, Asmawidjaja PS, Davelaar N, et al. Th17 cells, but not Th1 cells, from patients with early rheumatoid arthritis are potent inducers of matrix metalloproteinases and proinflammatory cytokines upon synovial fibroblast interaction,including autocrine interleukin-17A production[J]. Arthritis Rheum, 2011, 63(1): 73-83.
17.	Pöllinger B, Junt T, Metzler B, et al. Th17 cells, not IL-17+γδ T cells, drive arthritic bone destruction in mice and humans[J]. J Immunol, 2011, 186(4): 2602-2612.
18.	Braun T, Zwerina J. Positive regulators of osteoclastogenesis and bone resorption in rheumatoid arthritis[J]. Arthritis Res Ther, 2011, 13(4): 235.
19.	Mitsdoerffer M, Lee Y, Jäger A, et al. Proinflammatory T helper type 17 cells are effective B-cell helpers[J]. Proc Natl Acad Sci USA, 2010, 107(32): 14292-14297.
20.	Eklund CM. Proinflammatory cytokines in CRP baseline regulation[J]. Adv Clin Chem, 2009, 48: 111-136.

1. 　Imboden JB. The immunopathogenesis of rheumatoid arthritis[J]. Annu Rev Pathol, 2009, 4: 417-434.
2. 　Korn T, Bettelli E, Oukka M, et al. IL-17 and Th17 cells[J]. Annu Rev Immunol, 2009, 27: 485-517.
3. 　Nakae S, Nambu A, Sudo K, et al. Suppression of immune induction of collagen-induced arthritis in IL-17-deficient mice[J]. J Immunol, 2003, 171(11): 6173-6177.
4. 　Lubberts E, Koenders MI, Oppers-Walgreen B, et al. Treatment with a neutralizing anti-murine interleukin-17 antibody after the onset of collagen-induced arthritis reduces joint inflammation, cartilage destruction, and bone erosion[J]. Arthritis Rheum, 2004, 50(2): 650-659.
5. 　Sarkar S, Fox DA. Targeting IL-17 and Th17 cells in rheumatoid arthritis[J]. Rheum Dis Clin North Am, 2010, 36(2): 345-366.
6. 　Melis L, Vandooren B, Kruithof E, et al. Systemic levels of IL-23 are strongly associated with disease activity in rheumatoid arthritis but not spondyloarthritis[J]. Ann Rheum Dis, 2010, 69(3): 618-623.
7. 　Hitchon CA, Alex P, Erdile LB, et al. A distinct multicytokine profile is associated with anti-cyclical citrullinated peptide antibodies in patients with early untreated inflammatory arthritis[J]. J Rheumatol, 2004, 31(12): 2336-2346.
8. 　Mika K, Akito T, Hiroto M, et al. Interleukin-17 gene expression in patients with rheumatoid arthritis[J]. Mod Rheumatol, 2008, 18(1): 15-22.
9. 　Yamada H, Nakashima Y, Okazaki K, et al. Th1 but not Th17 cells predominate in the joints of patients with rheumatoid arthritis[J]. Ann Rheum Dis, 2008, 67(9): 1299-1304.
10. 　Cho ML, Yoon CH, Hwang SY, et al. Effector function of typeⅡ collagen-stimulated T cells from rheumatoid arthritis patients: cross-talk between T cells and synovial fibroblasts[J]. Arthritis Rheum, 2004, 50(3): 776-784.
11. 　Zhu JF, Yamane H, Paul WE. Differentiation of effector CD4 T cell populations[J]. Annu Rev Immunol, 2010, 28: 445-489.
12. 　盧月, 曹雅晶, 錢瑞琴. IL-17在類風濕關節炎發病機制中的作用[J]. 中國免疫學雜志, 2011, 27(9): 855-859.
13. 　Hwang SY, Kim JY, Kim KW, et al. IL-17 induces production of IL-6 and IL-8 in rheumatoid arthritis synovial fibroblasts via NF-kappaB- and PI3-kinase/Akt-dependent pathways[J]. Arthritis Res Ther, 2004, 6(2): 120-128.
14. 　Moran EM, Connolly M, Gao W, et al. Interleukin-17a induction of angiogenesis, cell migration, and cytoskeletal rearrangement[J]. Arthritis Rheum, 2011, 63(11): 3263-3273.
15. 　Shahrara S, Pickens SR, Mandelin AM, et al. IL-17-mediated monocyte migration occurs partially through CC chemokine ligand 2/monocyte chemoattractant protein-1 induction[J]. J Immunol, 2010, 184(8): 4479-4487.
16. 　Van HJ, Asmawidjaja PS, Davelaar N, et al. Th17 cells, but not Th1 cells, from patients with early rheumatoid arthritis are potent inducers of matrix metalloproteinases and proinflammatory cytokines upon synovial fibroblast interaction,including autocrine interleukin-17A production[J]. Arthritis Rheum, 2011, 63(1): 73-83.
17. 　Pöllinger B, Junt T, Metzler B, et al. Th17 cells, not IL-17+γδ T cells, drive arthritic bone destruction in mice and humans[J]. J Immunol, 2011, 186(4): 2602-2612.
18. 　Braun T, Zwerina J. Positive regulators of osteoclastogenesis and bone resorption in rheumatoid arthritis[J]. Arthritis Res Ther, 2011, 13(4): 235.
19. 　Mitsdoerffer M, Lee Y, Jäger A, et al. Proinflammatory T helper type 17 cells are effective B-cell helpers[J]. Proc Natl Acad Sci USA, 2010, 107(32): 14292-14297.
20. 　Eklund CM. Proinflammatory cytokines in CRP baseline regulation[J]. Adv Clin Chem, 2009, 48: 111-136.

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類風濕關節炎患者血清和關節液白細胞介素-17A與疾病活動的關系

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