膝骨关节炎与外周血IL-4、IL-6、IL-17A的相关性分析
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摘要
目的:比较膝骨关节炎患者及健康人群外周血中白细胞介素(IL)-4、IL-6、IL-17A的含量,研究IL-4、IL-6、IL-17A与膝骨关节炎严重程度的关系,探讨膝骨关节炎的发病机制。方法:选取膝骨关节炎患者67例为膝骨关节炎组,再选取同期体检的健康志愿者58例为健康对照组。检测2组外周血中IL-4、IL-6、IL-17A的水平,使用Lequesne指数评估骨关节炎的严重程度。结果:膝骨关节炎组外周血中IL-6、IL-17A含量较健康对照组高,差异有统计学意义(P<0.05),IL-4水平与健康对照组比较,差异无统计学意义(P>0.05);膝骨关节炎组外周血中IL-6、IL-17A的水平与膝骨关节炎的严重程度呈正相关(r=0.734,P<0.01;r=0.463,P<0.05)。结论:膝骨关节炎患者外周血中IL-6、IL-17A的表达明显升高,并且与病变严重程度呈正相关,IL-6、IL-17A可能参与了膝骨关节炎的病理过程,阻断IL-6、IL-17A信号通路,有望减轻及改善患者膝关节的破坏。
Objective:To compare the levels of IL-4,IL-6 and IL-17 A in peripheral blood of patients with knee osteoarthritis and healthy people,to study the relationship between the levels of IL-4,IL-6 and IL-17 A and the severity of knee osteoarthritis,and to explore the pathogenesis of knee osteoarthritis.Methods:Sixty-seven patients with knee osteoarthritis were selected as the knee osteoarthritis group,and 58 healthy volunteers were selected as the healthy control group.The levels of IL-4,IL-6 and IL-17 A in peripheral blood of the two groups were detected,and the severity of osteoarthritis was assessed by Lequesne index.Results:The levels of IL-6 and IL-17 A in the peripheral blood of the knee osteoarthritis group were higher than those of the healthy control group,with a statistical significance(P < 0.05).There was no significant difference in the levels of IL-4 between the knee osteoarthritis group and the healthy control group(P > 0.05).The levels of IL-6 and IL-17 A in peripheral blood of the knee osteoarthritis group were positively correlated with the severity of knee osteoarthritis(r = 0.734,P < 0.01;r = 0.463,P < 0.05).Conclusion:The expression of IL-6 and IL-17 A in the peripheral blood of patients with knee osteoarthritis is significantly increased and positively correlated with the severity of the disease.IL-6 and IL-17 A may be involved in the pathological process of knee osteoarthritis.Blocking IL-6 and IL-17 A signaling pathways is expected to reduce and improve the damage of knee joint.
Objective:To compare the levels of IL-4,IL-6 and IL-17 A in peripheral blood of patients with knee osteoarthritis and healthy people,to study the relationship between the levels of IL-4,IL-6 and IL-17 A and the severity of knee osteoarthritis,and to explore the pathogenesis of knee osteoarthritis.Methods:Sixty-seven patients with knee osteoarthritis were selected as the knee osteoarthritis group,and 58 healthy volunteers were selected as the healthy control group.The levels of IL-4,IL-6 and IL-17 A in peripheral blood of the two groups were detected,and the severity of osteoarthritis was assessed by Lequesne index.Results:The levels of IL-6 and IL-17 A in the peripheral blood of the knee osteoarthritis group were higher than those of the healthy control group,with a statistical significance(P < 0.05).There was no significant difference in the levels of IL-4 between the knee osteoarthritis group and the healthy control group(P > 0.05).The levels of IL-6 and IL-17 A in peripheral blood of the knee osteoarthritis group were positively correlated with the severity of knee osteoarthritis(r = 0.734,P < 0.01;r = 0.463,P < 0.05).Conclusion:The expression of IL-6 and IL-17 A in the peripheral blood of patients with knee osteoarthritis is significantly increased and positively correlated with the severity of the disease.IL-6 and IL-17 A may be involved in the pathological process of knee osteoarthritis.Blocking IL-6 and IL-17 A signaling pathways is expected to reduce and improve the damage of knee joint.
引文
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[17]曾天舒,陈璐璐,夏文芳,等.大鼠去卵巢后骨髓源性破骨细胞形成的动态变化及其与骨髓IL-6、IL-6受体表达的关系[J].中国骨质疏松杂志,2003,9(4):291-294.
[18]陈亮,梁津瑜,唐芳,等.白细胞介素17受体A特异性DNA适配子抑制小鼠实验性关节炎滑膜炎症[J].中华关节外科杂志(电子版),2015,9(1):78-82.
[19]SHABGAH AG,FATTAHI E,SHAHNEH FZ.Interleukin-17 in human inflammatory diseases[J].Postepy Dermatol Alergol,2014,31(4):256-261.
[20]WANG Z,ZHENG C,ZHONG Y,et al.Interleukin-17Can Induce Osteoarthritis in Rabbit Knee Joints Similar to Hulth's Method[J].Biomed Res Int,2017,2017:2091325.
[21]MENON B,GULLICK NJ,WALTER GJ,et al.Interleukin-17+CD8+T cells are enriched in the joints of patients with psoriatic arthritis and correlate with disease activity and joint damage progression[J].Arthritis Rheumatol,2014,66(5):1272-1281.
[22]ASKARI A,NAGHIZADEH MM,HOMAYOUNFARR,et al.Increased Serum Levels of IL-17A and IL-23 Are Associated with Decreased Vitamin D3 and Increased Pain in Osteoarthritis[J].PLoS One,2016,11(11):e0164757.
[23]张海森,白玉明,刘畅,等.关节腔注射富血小板血浆对膝骨关节炎患者关节液及血浆中IL-17的影响[J].中国修复重建外科杂志,2017,31(8):918-921.
[24]CURRENTLY.The Role of Inflammatory and AntiInflammatory Cytokines in the Pathogenesis of Osteoarthritis[J].Mediators Inflamm,2014:561459.
[2]KRAUS VB,KILFOIL TM,HASH TW,et al.Atlas of radiographic features of osteoarthritis of the ankle and hindfoot[J].Osteoarthritis Cartilage,2015,23(12):2059-2085.
[3]DILLON CF,RASCH EK,GU Q,et al.Prevalence of knee osteoarthritis in the United States:arthritis data from the Third National Health and Nutrition Examination Survey 1991-94[J].J Rheumatol,2006,33(11):2271-2279.
[4]DIEPPE PA,LOHMANDER LS.Pathogenesis and management of pain in osteoarthritis[J].Lancet,2005,365(9463):965-973.
[5]ALTMAN RD.Early management of osteoarthritis[J].Am J Manag Care,2010,16(2):S41-47.
[6]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[7]张志强.X线、超声及MRI影像诊断膝骨关节炎临床价值比较[J].泰山医学院学报,2018,39(1):90-91.
[8]王斌,汪志中,李新旭.膝骨关节炎患者血清炎性细胞因子的表达水平[J].现代诊断与治疗,2017,28(23):4322-4324.
[9]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[10]PASCARELLI NA,COLLODEL G,MORETTI E,et al.Changes in ultrastructure and cytoskeletal aspects of human normal and osteoarthritic chondrocytes exposed to interleukin-1βand cyclical hydrostatic pressure[J].Int J Mol Sci,2015,16(11):26019-26034.
[11]HU PF,CHEN WP,BAO JP,et al.Paeoniflorin inhibits IL-1β-induced chondrocyte apoptosis by regulating the Bax/Bcl-2/caspase-3 signaling pathway[J].Mol Med Rep,2018,17(4):6194-6200.
[12]KAYAL RA,SIQUEIRA M,ALBLOWI J,et al.TNF-αmediates diabetes-enhanced chondrocyte apoptosis during fracture healing and stimulates chondrocyte apoptosis through FOXO1[J].J Bone Mineral Res,2010,25(7):1604-1615.
[13]王红权,詹杰.白细胞介素家族在骨关节炎中的表达意义[J].现代免疫学,2016,36(3):261-264.
[14]GOLDRING MB.The Role of Cytokines as Inflammatory Mediators in Osteoarthritis:Lessons from Animal Models[J].Connect Tissue Res,1999,40(1):1-11.
[15]MILLWARD-SADLER SJ,WRIGHT MO,DAVIESLW,et al.Mechanotransduction via integrins and interleukin-4 results in altered aggrecan and matrix metalloproteinase 3 gene expression in normal,but not osteoarthritic,human articular chondrocytes[J].Arthritis Rheum,2000,43(9):2091-2099.
[16]KOTAKE S,SATO K,KIM KJ,et al.Interleukin-6 and soluble interleukin-6 receptors in the synovial fluids from rheumatoid arthritis patients are responsible for osteoclast-like cell formation[J].J Bone Miner Res,1996,11(1):88-95.
[17]曾天舒,陈璐璐,夏文芳,等.大鼠去卵巢后骨髓源性破骨细胞形成的动态变化及其与骨髓IL-6、IL-6受体表达的关系[J].中国骨质疏松杂志,2003,9(4):291-294.
[18]陈亮,梁津瑜,唐芳,等.白细胞介素17受体A特异性DNA适配子抑制小鼠实验性关节炎滑膜炎症[J].中华关节外科杂志(电子版),2015,9(1):78-82.
[19]SHABGAH AG,FATTAHI E,SHAHNEH FZ.Interleukin-17 in human inflammatory diseases[J].Postepy Dermatol Alergol,2014,31(4):256-261.
[20]WANG Z,ZHENG C,ZHONG Y,et al.Interleukin-17Can Induce Osteoarthritis in Rabbit Knee Joints Similar to Hulth's Method[J].Biomed Res Int,2017,2017:2091325.
[21]MENON B,GULLICK NJ,WALTER GJ,et al.Interleukin-17+CD8+T cells are enriched in the joints of patients with psoriatic arthritis and correlate with disease activity and joint damage progression[J].Arthritis Rheumatol,2014,66(5):1272-1281.
[22]ASKARI A,NAGHIZADEH MM,HOMAYOUNFARR,et al.Increased Serum Levels of IL-17A and IL-23 Are Associated with Decreased Vitamin D3 and Increased Pain in Osteoarthritis[J].PLoS One,2016,11(11):e0164757.
[23]张海森,白玉明,刘畅,等.关节腔注射富血小板血浆对膝骨关节炎患者关节液及血浆中IL-17的影响[J].中国修复重建外科杂志,2017,31(8):918-921.
[24]CURRENTLY.The Role of Inflammatory and AntiInflammatory Cytokines in the Pathogenesis of Osteoarthritis[J].Mediators Inflamm,2014:561459.
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