光动力疗法治疗早期类风湿关节炎的实验研究

摘要

目的 观察光动力疗法(PDT)对早期类风湿关节炎(RA)大鼠的治疗效果并探讨其作用机制.方法 32只SD大鼠任选8只作为空白对照组,其余24只均注射牛源性Ⅱ型胶原蛋白以建立RA动物模型；造模成功后随机将其分为模型对照组、药物治疗组、PDT治疗组；分别对各治疗组进行不同方式的治疗；定期测量各组大鼠右后足踝关节体积变化情况；治疗14d后,获取大鼠血清和踝关节组织,分别从血清学和病理学改变等方面进行实验分析研究.结果 ①治疗后PDT和药物治疗组大鼠右后足体积[(1.61±0.19),(1.57±0.13) cm3]较治疗前[(1.60±0.20),(1.61±0.16) cm3]变化不明显(P＞0.05),而模型对照组大鼠右后足体积(1.88±0.16) cm3较之前(1.63±0.13)cm3变化明显(P＞0.05)；②PDT和药物治疗组大鼠细胞因子的表达量白细胞介素(IL)-20[(37±11),(42±8)pg/ml]、转铁蛋白受体(sTfR)[(58±4),(63±5) pg/ml]较模型对照组IL-20 (63±7)pg/ml、sTfR(72±4) pg/ml有明显降低(P＜0.05)；PDT治疗组IL-20表达水平较药物治疗组有明显下降(P＜0.05)；③光学显微镜下病理切片结果显示:各治疗组大鼠右后足踝关节增生的滑膜减轻明显,生成的血管翳也相对减少,骨破坏程度较模型对照组有所减轻；同时PDT治疗组的滑膜增生程度较药物治疗组减轻明显,生成的血管翳也相对较少.结论 PDT治疗可以抑制RA动物模型滑膜细胞的增生,减少血管翳的形成,同时,能抑制细胞因子IL-20和sTfR的表达.%Objective To study the effects and the mechanisms of photodynamic therapy (PDT) on rats with early-stage rheumatoid arthritis (RA). Methods Of the 32 SD rats included in the study, 8 were allocated to blank control group, and the remaining 24 were randomly assigned to model control group (n=8), medication treatment group (n=8) and PDT treatment group (n=8) based on different intervention strategies, following injection of bovine-derived type Ⅱ collagen protein to establish the RA model, for subsequent assessment of changes in the volume of right posterior ankle at given intervals. The sera were sampled from the abdominal aorta and the ankle tissues were harvested at day 14 for serological and pathological evaluation. Results Treatment using PDT and medications did not result in marked changes in the volume of right posterior ankle [(1.61 ±0.19) vs (1.57±0.13) cm3, (1.60±0.20) vs (1.61 ±0.16) cm3, both P＞0.05] when compared with that of model control group [(1.88±0.16) cm3 vs (1.63±0.13) cm3, P＜0.05)]. A significantly reduced level of IL-20 [(37±11) and (42±8) vs (63±7)pg/ml, P＜0.05] and sTfR [(58±4) and (63±5) vs (72± 4) pg/ml, P＜0.05] was noted in PDT and medication treatment groups, but not in model control group. Treatment with PDT yielded a more impressive decrease in the level of IL-20 than medications (P＜0.05). Under light microscope, biopsy of the right posterior ankle evidenced the markedly attenuated synovial proliferation, reduced pannus growth and minor bone destruction in both treatment groups, which were predominated in PDT group. Conclusion PDT may inhibit synovial cell proliferation, attenuate pannus formation and suppress IL-20 and sTfR expression in animal models with RA.