类风湿关节炎患者RANTES及MCP-1测定及其意义.docVIP

类风湿关节炎患者RANTES及MCP-1测定及其意义 　 作者：李国辉　姚航平　李志会方 【关键词】 T细胞表达;分泌因子;单核细胞趋化蛋白1;类风湿关节炎 ［摘要］ 目的研究类风湿关节炎（RA）患者血清、关节滑液中调节活化正常T细胞表达和分泌因子（RANTES）及单核细胞趋化蛋白1（MCP-1）表达水平，探讨其在RA致病中的作用。方法用酶联免疫吸附法（ELISA）测定27例类风湿关节炎患者血清及病变膝关节滑液中RANTES、MCP-1水平，并与外伤截肢者对照。结果 RA患者血清及滑液中RANTES、MCP-1水平明显高于对照组，且RA滑液中RANTES水平高于血清。结论以上研究结果提示RA病变关节组织是RANTES产生的主要部位。 　　［关键词］ T细胞表达;分泌因子;单核细胞趋化蛋白1;类风湿关节炎 　　Expression of RNATES，MCP-1in serum and synovial fluid in patients with rheumatoid arthritis 　　［Abstract］ Objective To investigate the expression of activation normal T cell expressed and secreted（RANTES）and monocytechemoattracta protein1（MCP-1）in serum and synovial fluid of patients with rheumatoid arthritis（RA）and to identify its pathological role in RA.Methods The serum and synovial fluid of the pathologic knee joints were obtained from patients with RA，and samples from leg traumatic amputees were used as the control group.Levels of RANTES and MCP-1protein in serum and synovial fluid were measured by enzyme-linked immunosorbent assay（ELISA）.Results Levels of RANTES，MCP-1protein in both serum and synovial fluid of patients with RA were significantly higher com-pared with corresponding samples of the control group.In addition，the expression of RANTES protein in synovial fluid was also markedly increased compared with that in serum of patients with RA.Conclusion All the results suggest that the pathological arthrosis are the main positions to produce RANTES. 　　［Key Words］ RANTES;MCP-1;rheumatoid arthritis; 　　类风湿关节炎（rheumatoid arthritis，RA）的病理特点为大量炎性细胞在滑膜的浸润和在滑液的渗出，滑膜增生、血管翳形成，及由此造成的软骨破坏。研究发现趋化因子在RA关节的炎性细胞关节浸润中起着极为重要的作用 ［1］ 。调节活化正常T细胞表达和分泌因子（regulated on activation normal T cell expressed and secreted，RANTES）及单核细胞趋化蛋白1（monocytechemoattracta protein1，MCP-1）均为炎症 性趋化因子，具有调节T淋巴细胞分化的功能。在炎症条件下，MCP-1和RANTES增多能募集包括活化的效应T淋巴细胞进入组织的炎症损伤部位执行免疫应答功能 ［2］ 。本研究对RA患者血清和病变膝关节滑液中RANTES和MCP-1水平进行检测，并与外伤截肢者对照，旨在探讨其在RA发病中的作用。 　　1材料和方法 1.1研究对象 　　实验组血清及膝关节滑液取材于2002年至2005年杭州市红十字会医院及浙江大学医学院附属第一医院风湿科初诊RA病人，共27例，均符合1987年美国风湿病协会修订的类风湿