首页
皮肌炎患者外周血急性时相反应物水平与IL-6、疾病活动度的相关性分析
Levels of Acute-phase-reactants in Patient with Dermatomysitis and Its Correlations with IL-6 and Dermatomyositis Disease Activity
-
摘要: 目的 分析皮肌炎患者外周血急性时相反应物(APR)水平与白介素(IL)-6、疾病活动度的相关性。 方法 采用化学发光法检测31例皮肌炎患者外周血APR (C反应蛋白、血清淀粉样蛋白A及血清铁蛋白)水平,与23例系统性红斑狼疮、22例类风湿关节炎、18例原发性干燥综合征患者相关APR水平对比,并分析皮肌炎患者APR与外周血IL-6的相关性;采用肌炎活动性评价工具评价皮肌炎患者的临床病情指标,分析其与外周血APR的相关性。 结果 皮肌炎患者外周血C反应蛋白[(17.08±17.18) mg/L]低于类风湿关节炎患者[(85.95±60.62) mg/L,P<0.000 1]、系统性红斑狼疮患者[(51.34±52.98) mg/L,P=0.006]及原发性干燥综合征患者[(47.00±47.24) mg/L,P=0.018]。皮肌炎患者血清淀粉样蛋白A[(92.04±98.93) mg/L]低于类风湿关节炎[(311.30±292.45) mg/L,P=0.002]及原发性干燥综合征患者[(284.31±325.30) mg/L,P=0.025],血清铁蛋白[(510.10±610.73) ng/mL]高于原发性干燥综合征患者[(220.33±164.07) ng/mL,P=0.02],略高于类风湿关节炎及系统性红斑狼疮患者,但差异无统计学意义。上述APR水平均与外周血IL-6水平呈正相关,C反应蛋白及血清铁蛋白分别仅与疾病活动性评估指标中的一般情况及肺部表现相关,与其他各系统及整体病情活动无关。 结论 皮肌炎患者APR增高水平低于其他常见结缔组织病,与IL-6相关,与疾病整体活动性无相关性。Abstract: Objective To determine the association between acute-phase-reactants (APR) and interleukin-6 (IL-6) in patient with dermatomysitis (DM). Methods The levels of C-reactive protein (CRP), serum amyloid A protein (SAA) and serum ferritin (SF) in peripheral blood of 31 adult DM patients were determined by chemiluminescence immunoassay, and compared with those of 23 patients with systemic lupus erythematosus (SLE), 22 patients with rheumatoid arthritis (RA), and 18 patients with Sjögren syndrome (SS). The correlations between the levels of those APR and IL-6 were examined. We also measured dermatomyositis disease activity using myositis disease activity assessment tool (MDAAT), and examined its association with APR levels. Results DM patients had significantly lower level of CRP[(17.08±17.18)mg/L] than those patients with RA[(85.95±60.62)mg/L, P<0.000 1], SLE[(51.34±52.98)mg/L, P=0.006] and SS[(47.00±47.24) mg/L, P=0.018]. DM patients had significantly lower level of SAA[(92.04±98.93) mg/L] than those patients with RA[(311.30±292.45) mg/L, P=0.002] and SS[(284.31±325.30) mg/L, P=0.025]. DM patients had significantly higher level of SF[(510.10±610.73)ng/mL] than those patients with SS[(220.33±164.07) ng/mL, P=0.02], as well as those with RA and SLE albeit without statistical significance. All of the three APRs were positive correlated with IL-6 level. No significant associations between APR and systemic or global disease activities were found, although CRP was associated with constitutional disease activity and SF was associated with pulmonary disease activity. Conclusion DM patients have lower levels of elevated APR than the other three common connective tissue diseases, which is associated with IL-6 but not with global disease activity.
-
Keywords:
- Dermatomysitis /
- C-reactive protein /
- Serum amyloid A protein /
- Serum ferritin /
- Interleukin-6 /
- Disease activity
-
-
[1] Schnabel A. Interstitial lung disease in polymyositis/dermatomyositis. Z Rheumatol,2013;72(3):220-226.
[2] Faith M, Dastmalchi M, Rasmussen E, et al. Interstitial lung disease, a common manifesttation of newly diagnosed polymyositis and dermatomyositis. Ann Rheum Dis,2002;63(3):297-301.
[3] Bohan A, Peter IB. Polymyositis and dermatomyositis (first of two parts). N Eng J Med,1975;292(7):344-347.
[4] Bohan A, Peter IB. Polymyositis and dermatomyositis (second of two parts). N Eng J Med,1975;292(7):403-407.
[5] Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rhuem,1997;40(9):1725.
[6] Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria-an American College of Rheumatology/European League Against Rheumatism Collaborative initiative. Arthritis Rheum,2010;69(9):2569-2581.
[7] Vatajli C, Bombardiere S, Jonsson R, et al. Classification criteria for Sjogren's syndrome:a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rhuem Dis,2002;61(6):554-558.
[8] Greenberg SA. Proposed immunologic models of the inflammatory myopathies and potential therapeutic implications. Neurology,2007;69(21):2008-2019.
[9] Kawai T. Inflammatory markers, especially the mechanism of increased CRP. Rinsho Byori,2000;48(8):719-721.
[10] Madsen OR. Agreement between the DAS28-CRP assessed with 3 and 4 variables in patients with rheumatoid arthritis treated with biological agents in the daily clinic. J Rheumatol,2013;40(4):379-385.
[11] Zandman-Goddard G, Shoenfeld Y. Ferritin in autoimmune diseases. Autoimmun Rev,2007;6(7):457-463.
[12] Robinson AB, Reed AM. Clinical features, pathogenesis and treatment of juvenile and adult dermatomyositis. Nat Rev Rheumatol,2011;7(11):664-675.
[13] Nyberg P, Wikman AL, Nennesmo I, et al. Increased expression of interleukin 1 alpha and MHC class Ⅰ in muscle tissue of patients with chronic, inactive polymyositis and dermatomyositis. J Rheumatol,2000;27(4):940-948.
[15] Gono T, Kawaguchi Y, Hara M, et al. Increased ferritin predicts development and severity of acute interstitial lung disease as a complication of dermatomyositis. Rheumatology,2010;49(7):1354-1360.
[16] Gono T, Miyake K, Kawaguchi Y, et al. Hyperferritinaemia and macrophage activation in a patient with interstitial lung disease with clinically amyopathic DM. Rheumatology,2012;51(7):1336-1338.
[17] Bilgic H, Ytterberg SR, Amin S, et al. Interleukin-6 and type Ⅰ interferon-regulated genes and chemokines mark disease activity in dermatomyositis. Arthritis Rheum,2009;60(11):3436-3446.
[18] Murakami M, Hirano T. The pathological and physiological roles of IL-6 amplifier activation. Int J Biol Sci,2012;8(9):1267-1280.
[19] Ash A, Emery P. The role of Tocilizumab in the management of rheumatoid arthritis. Expert Opinn Biol Ther,2012;12(9):1277-1289.
[20] 舒晓明, 马丽, 卢昕等.肌炎活动性评价工具在中国多发性肌炎/皮肌炎患者中的应用. 中华医学杂志,2011;91(19):1328-1330.
计量
- 文章访问数: 2882
- HTML全文浏览量: 133
- PDF下载量: 29
下载:
