强直性脊柱炎患者血清白细胞介素18检测的意义

目的探讨白细胞介素18(IL-18)在强直性脊柱炎(AS)发病中的作用及其血清水平检测的临床意义。方法采用酶联免疫吸附试验法(ELISA)检测53例活动期AS患者与40例健康对照组血清IL-18及肿瘤坏死因子α(TNF-α)的水平,并动态观察治疗前后IL-18及TNF-α的变化及其与病情活动指标之间的关系。结果AS患者治疗前血清IL-18水平明显高于健康对照组[(415.7±30.4)ng/L比(45.7±10.4)ng/L,P<0.05)],并与TNF-α、Bath强直性脊柱炎病情活动性指数(BASDAI)、晨僵时间、Bath强直性脊柱炎功能指数(BASFI)和Bath强直性脊柱炎脊柱活动测量指数(BASMI)呈正相关(r分别为0.52、0.63、0.48、0.58和0.48,P均<0.01)。治疗12周、24周后AS患者血清IL-18水平分别为(323.6±85.8)和(220.1±15.1)ng/L,均较治疗前明显下降,且治疗24周后下降更明显。结论IL-18可能参与AS发病机制,血清IL-18的检测可作为反映AS病情活动的指标之一。     

TNF-α在强直性脊柱炎患者血清中的表达

肿瘤坏死因子一仅（TNF-α）是一种具有杀伤肿瘤细胞功能的促炎细胞因子,主要由活化的单核巨噬细胞产生,具有多种生物学功能,在炎症反应、免疫调节中起重要作用。在免疫病理发病机制的研究中发现,强直性脊柱炎（AS）的发病与促炎细胞因子表达的上调有关,其中较为重要并为多数学者所公认的细胞因子是TNF-α。     

强直性脊柱炎患者血清Dickkopf-1蛋白水平分析

目的:分析强直性脊柱炎(AS)患者血清Dickkopf-1蛋白(DKK-1)水平变化并探讨其临床应用价值。方法:选取2016-12—2018-06我院诊治的50名AS患者[AS组,其中21例患者使用肿瘤坏死因子-α(TNF-α)抑制剂治疗(使用TNF-α抑制剂治疗组),29例患者未使用TNF-α抑制剂治疗(未使用TNF-α抑制剂治疗组)],另选取同期50名健康体检者为健康对照(对照组)。检测两组患者血清DKK-1、红细胞沉降率(ESR)和C-反应蛋白(CRP)水平。比较AS组患者治疗前后疾病活动度BASDAI、DKK-1、ESR及CRP水平变化。同时分析AS患者DKK-1与BASDAI、ESR及CRP的相关性。结果:AS组患者血清DKK-1水平明显低于对照组(P<0.01)。治疗6个月后,AS患者各亚组BASDAI、ESR及CRP水平较治疗前明显下降(P<0.01),且使用TNF-α抑制剂治疗组较未使用TNF-α抑制剂治疗组下降更明显(P<0.01);两组DKK-1水平与治疗前差异均无统计学意义(P>0.05)。AS患者各亚组血清DKK-1与BASDAI、ESR和CRP水平均无明显相关性。结论:DKK-1可能参与AS的新骨形成。TNF-α抑制剂可能对AS新骨形成无阻止作用。     

白细胞介素18与肿瘤

白细胞介素18(IL-18)是一种细胞因子，早期称IGIF(IFN-γ inducing factor)。来源于单核细胞及巨噬细胞，具有刺激T细胞增殖，增强Th及NK细胞活性，并具有抗肿瘤、抗感染等多种生物学作用，本文就其生物学活性以及抗肿瘤作用作一综述。     

白细胞介素18与肿瘤

白细胞介素 18(IL 18)是一种细胞因子 ,早期称IGIF(IFN γinducingfactor)。来源于单核细胞及巨噬细胞 ,具有刺激T细胞增殖 ,增强Th及NK细胞活性 ,并具有抗肿瘤、抗感染等多种生物学作用 ,本文就其生物学活性以及抗肿瘤作用作一综述。     

系统性红斑狼疮患者血清白细胞介素-18水平变化的意义

目的探讨系统性红斑狼疮（SLE）中白细胞介素-18（IL-18）的表达及其临床意义。方法应用双抗体夹心酶联免疫吸附实验（ELISA）方法分别测定50例SLE患者血浆的IL-18水平。结果SLE患者血清IL-18水平增高,活动期组较稳定期组增高明显（P〈0．05）,与正常对照组比较差异具有显著性（P〈0．05）。SLE患者治疗后IL-18水平低于治疗前水平（P〈0．05）。结论SLE患者血清IL-18水平显著增高,与SLE的病情活动密切相关,检测IL-18对SLE病情的判断有一定的价值。     

骨关节炎患者白细胞介素-18水平分析

骨关节炎（Osteoarthritis,OA）是临床最常见的关节疼痛和退行性疾病,细胞因子和炎性介质在OA的发生和发展中起着重要作用。新近发现致炎因子白细胞介素-18（IL-18）是OA发病机制中一种重要的炎症介质,能诱导细胞大量合成γ-干扰素,促进肿瘤坏死因子-α（TNF-α）、IL-1β和多种趋化因子的合成表达,能作用于关节软骨细胞和滑膜组织,调节细胞应答,反映关节滑膜炎症程度。本文采用ELISA和RT-PCR检测不同放射学分级OA患者血清、关节液IL-18水平及滑膜组织IL-18mR-NA表达变化,为临床治疗OA提供新途径。     

肿瘤坏死因子-α 5 旁侧基因多态性与强直性脊柱炎相关性

目的探讨肿瘤坏死因子α基因多态性与强直性脊柱炎(AS)发生的易感关系。方法采用序列特异引物PCR方法(SSP-PCR)检测了136例AS患者和127例正常人的TNF-α5旁侧-857C/T,-863C/A和-1031T/C三个基因多态性位点,并比较了部分不同地区人群之间的基因型与等位基因频率。结果AS患者TNF-α-857基因型(CC,TC和TT)分布频率分别是64.0%,35.3%和0.7%;TNF-α-863基因型(CC,CA和AA)分布频率分别是68.4%,30.0%和1.5%;TNF-α-1031基因型(TT,TC和CC)分布频率分别是66.2%,32.4%和1.5%;TNF-α-857等位基因频率C和T分别是81.6%和18.8%;TNF-α-863等位基因频率C和A分别是83.5%和16.5%;TNF-α-1031等位基因频率T和C分别是:82.4%和17.6%;正常对照者TNF-α-857基因型(CC,TC和TT)分布频率分别是70.9%,27.6%和1.6%;TNF-α-863基因型(CC,CA和AA)分布频率分别是68.5%,29.9%和1.6%;TNF-α-1031基因型(TT,TC和CC)分布频率分别是69.3%,29.1%和1.6%;TNF-α-857等位基因频率C和T分别是84.6%和15.4%;TNF-α-863等位基因频率C和A分别是83.5%和16.5%;TNF-α-1031等位基因频率T和C分别是:83.9%和16.1%;AS患者和正常对照者之间的基因型分布和等位基因频率比较差异无显著性,(P>0.05);本文中国汉族人TNF-α-857(C/T),-863(C/A),-1031(T/C)位点基因多态性分布同亚洲的日本、韩国人群基本一致,差异无显著性;-863(C/A),-1031(T/C)位点基因多态性分布同欧洲的英国、荷兰、瑞典人群比较差异也无显著性,但欧洲人群的TNF-α-857T的等位基因频率明显高于亚洲人群,差异有显著性(P<0.05)。结论TNF-α-857,-863和-1031三个基因多态性位点可能不是中国人患AS的主要易感位点基因。     

系统性红斑狼疮患者血清IL-10和IL-18的检测及意义

目的探讨系统性红斑狼疮（SLE）患者血清IL-10和IL-18的表达及其与疾病活动的关系。方法应用ELISA法检测104例SLE患者和100例健康体检者血清IL-10和IL-18的水平,其中SLE患者根据疾病活动性指数（SLEDAI）评分标准分为活动组（56例）和缓解组（48例）,比较各组结果的差异,并分析SLEDAI与IL-10和IL-18的相关性。结果 SLE组IL-10和IL-18水平分别为（18.25±3.66）、（582.61±65.28）pg/ml,明显高于对照组的（7.12±2.36）、（186.24±60.39）pg/ml,差异有统计学意义（P〈0.01）;SLE活动组IL-10和IL-18水平分别为（25.98±4.75）、（683.72±62.48）pg/ml,高于缓解组的（14.67±3.21）、（493.51±69.17）pg/ml,差异亦有统计学意义（P〈0.01）;SLE患者血清IL-10和IL-18水平与SLEDAI呈正相关（P〈0.05）。结论 IL-10和IL-18在SLE发病机制中发挥重要作用,而且与疾病活动性相关。     

Evaluation of serum paraoxonase and arylesterase activities in ankylosing spondylitis patients

OBJECTIVES

The aim of this study was to investigate the activities of serum paraoxonase and arylesterase in patients with ankylosing spondylitis with respect to those of healthy controls, to assess whether these enzyme levels are related to disease activity and functional capacity.

METHODS

The study included 32 patients with ankylosing spondylitis whose diagnoses were made according to the modified New York criteria as well as 25 healthy controls matched for age and sex. The Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index were applied to the ankylosing spondylitis patients. As laboratory parameters, the erythrocyte sedimentation rate and serum C-reactive protein level were measured in patients and control subjects. Paraoxonase and arylesterase enzyme activities were measured using appropriate methods.

RESULTS

No statistically significant differences (p>0.05) were found between the ankylosing spondylitis patients and controls in terms of serum paraoxonase or arylesterase levels. Furthermore, there was no correlation between clinical and laboratory parameters in patients with ankylosing spondylitis.

CONCLUSION

Serum paraoxonase and arylesterase levels in ankylosing spondylitis patients may not differ from those of healthy controls, and there is no significant correlation between antioxidant parameters and the Bath Ankylosing Spondylitis Disease Activity Index or Bath Ankylosing Spondylitis Functional Index scores in ankylosing spondylitis patients. Further research is needed to provide deeper understanding of this disease.     

Clinical significance of serum IL-18 determination in rheumatoid arthritis

Interleukin (IL)-18 is a novel cytokine expressing at inflammatory lesion. In this study, to evaluate the clinical significance of IL-18 determination, we have examined serum IL-18, inflammation markers, sFas, and sFas-ligand concentrations in patients with rheumatoid arthritis(RA). Serum was obtained from 56 RA patients aged 35-74 years, 16 osteoarthritis (OA) patients aged 36-78 years and 178 healthy subjects aged 20-72 years and IL-18 was measured by ELISA. Serum IL-18 concentrations in RA (240.1 +/- 15.6 pg/ml, mean +/- SE) were significantly higher than OA (151.8 +/- 12.7 pg/ml, p < 0.005) and healthy controls(141.5 +/- 26.1 pg/ml, p < 0.001). Serum IL-18 levels were significantly increased in II to IV stages of RA (stage II; 218.6 +/- 31.2 pg/ml, stage III; 258.7 +/- 38.4 pg/ml, stage IV; 231.6 +/- 13.1 pg/ml) than those in OA. Furthermore, a positive correlation was observed between serum IL-18 concentration and serum Fas level in patients with RA (r = 0.472), whereas there was no significant correlation between serum IL-18 and sFas-ligand or other inflammatory markers (CRP, RF, CA-RF, IL-6, and IL-8). The present study showed that serum IL-18 level increased in RA, but it is unknown how IL-18 is involved in the pathogenesis of RA. Further study will be necessary to clarify the role of IL-18 in RA.     

Genetics of ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis that affects the spine and sacroiliac joints. It causes significant disability and is associated with a number of other features including peripheral arthritis, anterior uveitis, psoriasis and inflammatory bowel disease (IBD). Significant progress has been made in the genetics of AS have in the last five years, leading to new treatments in trial, and major leaps in understanding of the aetiopathogenesis of the disease.     

白细胞介素10启动子基因多态性与强直性脊柱炎的易感性

背景：在强直性脊柱炎患者中,基因多态性很可能影响细胞因子的分泌模式。 目的：在中国胶东半岛地区汉族人强直性脊柱炎患者中,探讨白细胞介素10启动子基因的单核苷酸多态性和单体型与强直性脊柱炎易感性的相关性。 方法：用酶联免疫吸附测定法测定血清中白细胞介素10的水平,用聚合酶链反应和限制性片段长度多态性方法对白细胞介素10基因启动子中的-1082A/G、-819C/T和-592C/A位点的单核苷酸多态性进行分析。 结果与结论：收集了110例强直性脊柱炎患者和120例同种族的健康人,强直性脊柱炎患者组血清中白细胞介素10水平明显高于健康对照组(Z=10.9,P < 0.001),单核苷酸多态性分析显示：在强直性脊柱炎患者组和健康对照组之间-592A/C位点基因型分布和等位基因频率没有明显差异,该研究中没有发现-1082GG基因型。强直性脊柱炎患者-1082G等位基因频率较健康对照组增加(P=0.047),通过logistic回归分析,强直性脊柱炎患者-1082AG基因型的比值比为1.993(95%CI：1.046-3.800,P=0.034 ),而-819CC基因型的比值比为3.125(95%CI：1.246-7.836,P=0.015),此外,单体型分析显示与ATA 基因型相比,GCC基因型显著增加了患强直性脊柱炎的风险(OR=2.19,95%CI：1.13- 4.26,P= 0.020)。结果表明白细胞介素10的基因单体型与中国胶东半岛地区汉族人强直性脊柱炎的易感因素相关。     

Etanercept: in ankylosing spondylitis

Etanercept is a dimeric fusion protein based on the p75 tumor necrosis factor (TNF) receptor. It binds to TNFalpha and blocks its biological activity. Subcutaneous etanercept is effective in the treatment of rheumatoid arthritis, psoriatic arthritis, and polyarticular-course juvenile rheumatoid arthritis. More recently, etanercept has shown efficacy in the treatment of adults with ankylosing spondylitis. In randomized, double-blind, placebo-controlled trials, subcutaneous etanercept 25mg twice weekly for 6-24 weeks significantly reduced disease activity in patients with active ankylosing spondylitis. In the largest trial, etanercept produced a response rate of 57% compared with 22% for placebo after 24 weeks (response was determined via the validated ASAS 20 response criteria developed by the Assessments in Ankylosing Spondylitis [ASAS] Working Group). Etanercept therapy significantly improved health-related quality of life in patients with ankylosing spondylitis compared with placebo. The greatest improvements in a 16-week study were seen in the domains of physical functioning, physical role, bodily pain, vitality, and social functioning. Etanercept was generally well tolerated, with few serious adverse events or treatment withdrawals. The most common adverse events were injection-site reactions and minor upper respiratory tract infections.     

Impaired gait in ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. The spine becomes rigid from the occiput to the sacrum, leading to a stooped position. This study aims at evaluating AS subjects gait alterations. Twenty-four subjects were evaluated: 12 normal and 12 pathologic in stabilized anti-TNF-alpha treatment (mean age 49.42 (10.47), 25.44 (3.19) and mean body mass index 55.75 (3.19), 23.73 (2.7), respectively). Physical examination and gait analysis were performed. A motion capture system synchronized with two force plates was used. Three-dimensional kinematics and kinetics of trunk, pelvis, hip, knee and ankle were determined during gait. A trend towards reduction was found in gait velocity and stride length. Gait analysis results showed statistically significant alterations in the sagittal plane at each joint for AS patients (P < 0.049). Hip and knee joint extension moments showed a statistically significant reduction (P < 0.044). At the ankle joint, a decreased plantarflexion was assessed (P < 0.048) together with the absence of the heel rocker. Gait analysis, through gait alterations identification, allowed planning-specific rehabilitation intervention aimed to prevent patients’ stiffness together with improve balance and avoid muscles’ fatigue.