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目的分析A20和NF-κB基因在类风湿关节炎(RA)患者外周血和关节液中的表达水平及治疗前后表达水平的变化,探讨A20在RA炎症发生发展的作用。方法利用实时荧光定量PCR(q RT-PCR)检测RA患者外周血和关节液中单个核细胞A20和NF-κB基因表达水平以及RA患者治疗前(疾病活动期)和治疗后3个月外周血单个核细胞(PBMCs)A20和NF-κB基因表达水平。结果 1)疾病活动期54例RA患者PBMCs中A20表达水平(6.52±5.85)明显低于健康对照组(34.47±26.55,P<0.001),NF-κB表达水平(1.55±2.02)高于健康对照组(0.59±0.16,P=0.046);2)14例RA患者PBMCs中A20(8.07±6.25)和NF-κB(7.11±19.01)与关节液单个核细胞A20(7.74±5.74)和NF-κB(0.76±0.24)表达水平差异无统计学意义(P>0.05);3)19例RA患者治疗后3月病情明显缓解,治疗后PBMCs中A20表达水平(10.18±13.22)较治疗前(2.32±1.87)明显升高(P=0.019),但治疗后外周血A20表达水平仍然明显低于健康对照组(P<0.001);NF-κB表达水平在治疗前后无明显变化(P=0.403)。结论 RA患者外周血A20表达水平明显降低,并与NF-κB表达水平上调相对应,而RA疾病缓解后,A20表达水平有所恢复。RA患者关节液中A20和NF-κB表达水平与患者外周血中A20和NF-κB相似。
Objective To analyze the expression of A20 and NF-κB in peripheral blood and synovial fluid of patients with rheumatoid arthritis (RA) and their changes before and after treatment, and to explore the role of A20 in the development of RA inflammation. Methods The expression of A20 and NF-κB in peripheral blood and synovial fluid of RA patients were detected by real-time quantitative PCR (q RT-PCR), and the levels of A20 and NF-κB in RA patients before treatment (active disease) and 3 months after treatment Mononuclear cells (PBMCs) A20 and NF-κB gene expression levels. Results 1) The expression level of A20 in PBMCs in active RA patients (6.52 ± 5.85) was significantly lower than that in healthy controls (34.47 ± 26.55, P <0.001), and the expression level of NF-κB (1.55 ± 2.02) was higher in healthy RA patients than in healthy controls (0.59 ± 0.16, P = 0.046); 2) A20 (8.07 ± 6.25) and NF-κB (7.11 ± 19.01) in PBMCs of RA patients were significantly associated with A20 (7.74 ± 5.74) and NF- (0.76 ± 0.24) (P> 0.05); 3) The symptoms of 19 RA patients were relieved at 3 months after treatment, the expression level of A20 in PBMCs after treatment (10.18 ± 13.22) was significantly higher than that before treatment 1.87) (P = 0.019). However, the expression of A20 in peripheral blood was still significantly lower than that in healthy controls (P <0.001). The expression of NF-κB had no significant change before and after treatment (P = 0.403). Conclusion The expression of A20 in peripheral blood of patients with RA is significantly lower than that in patients with RA, and the level of A20 is up-regulated in RA patients. The levels of A20 and NF-κB in the synovial fluid of RA patients were similar to those of A20 and NF-κB in peripheral blood of RA patients.