摘要
目的探讨幼年特发性关节炎(JIA)患儿血清IL-17及可溶性核因子(NF)-κB受体活化因子配体(sRANKL)变化的临床意义。方法采用ELISA法检测62例JIA活动期患儿(全身型24例、多关节型20例、少关节型18例)及26例年龄、性别无显著差异的健康儿童血清IL-17和sRANKL水平;抗风湿病治疗4～8周,采用同样方法复查患儿血清IL-17及sRANKL水平。结果活动期JIA患儿组血清IL-17水平高于健康对照组,差异均有统计学意义(P<0.05);其中全身型患儿血清IL-17水平稍高于健康对照组,差异无统计学意义(P>0.05);而多关节型及少关节型患儿血清IL-17水平均明显高于健康对照组,差异均有统计学意义(Pa<0.05)。活动期JIA患儿组血清sRANKL水平明显高于健康对照组,差异有统计学意义(P<0.05);其中全身型、多关节型及少关节型患儿血清sRANKL水平均明显高于健康对照组,差异均有统计学意义(Pa<0.05);多关节型及少关节型JIA患儿血清IL-17水平与血清sRANKL水平呈正相关(r=0.347、0.228,Pa<0.05)。抗风湿药物治疗4～8周复查,JIA活动期患儿血清IL-17及sRANKL水平均较治疗前明显下降,差异均有统计学意义(P<0.01,0.05),且伴有受累关节肿胀、压痛及活动受限明显改善。结论 IL-17及其诱导而产生的多种细胞因子具有较强的致炎性和具有强的诱导基质金属蛋白酶的作用;同时sRANKL则有促使破骨细胞产生的作用;血清IL-17和sRANKL测定是判定JIA患儿病情的重要生物学标志之一。
Objective To explore the clinical significance of changes of serum interleukin - 17 （ IL - 17 ） and soluble receptor activator of nuclear factor（NF） - κB ligand （sRANKL） levels in children with juvenile idiopathic arthritis （JIA）. Methods Blood samples from 62 active JIA children （ systemic 24 cases, polyarticular 20 cases, and oligoarticular 18 cases） and 26 age - and sex - matched normal controls were all assayed by enzyme - linked immunosorbent assay （ELISA） before antirheumatic therapy. After 4 - 8 weeks antirheumatic therapy, the blood samples of these children were assayed again by using the same method. Results Serum IL - 17 level in active JIA children was signifi- cantly higher than that in normal controls （P 〈 0.05 ）, and serum IL - 17 level in systemic subtype was slightly higher than that in normal controls without statistical difference（ P 〉 0.05 ） ; but the elevated serum IL - 17 level in either polyarticular or oligoarticular group was statistically higher than that in controls （Pa 〈 0.05 ）. The serum sRANKL level in active JIA children was statistically higher than that in normal controls （ P 〈 0.05 ）, and the serum sRANKL level in subtype of systemic, polyarticular or oligoarticular groups were statistically higher than in the normal controls （ P 〈 0.05 ）. There was positive correlation between serum IL - 17 level and serum sRANKL level （ r = 0. 347,0. 228, P 〈 0.05 ）in both polyarticular and oligoarticular groups. After antirheumatic agent therapy for 4 -8 weeks, the elevated serum IL- 17 level and sRANKL level all dropped down statistically from those assayed before therapy （ P 〈 0.01,0.05 ） ,with obvious improvement of disease in relieving swelling of joint,tenderness and movement limitation. Conclusions IL - 17 and the cytokines induced by it are potent to cause in- flammation and production of matrix metalloproteinase and the increase in sRANKL resulted in promotion of osteoblast production so that serum IL - 17 and sRANKL may be useful biomarkers for following up JIA patients concomitantly.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第21期1642-1644,共3页
Journal of Applied Clinical Pediatrics
