Objective： To study the expression of vitamin D receptor (VDR) mRNA in peripheral blood monocytes of patients with Ankylosing Spondylitis (AS) and explore the correlation between the disease activity [erythrocyte sedimentation rate (ESR) , C-reactive protein (CRP) , Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)]and the serum levels of 25-hydroxyvitamin D3 [25-D/ 25- (OH) D3]and 1,25-Dihydroxy vitamin D3 [1, 25-D/1, 25- (OH) 2D3)]in AS patients.Methods： Twenty- six patients with AS and 13 age- and sex-matched healthy controls were included.Ficoll density gradient centrifugation method was used to segregate peripheral blood mononuclear cells.Subsequently, total RNA in isolated monocytes was extracted by Trizol and reverse transcripted into cDNA.The VDR mRNA expression was examined by real time fluorescent quantitative reverse transcriptase polymerase chain reaction (real-time qRT-PCR) and quantified using the 2-Δ ΔCT method.The serum levels of 25-D and 1, 25-D were measured by enzyme linked immuno-sorbent assay (ELISA).The correlations between disease activity (ESR, CRP and BASDAI) and expression of VDR mRNA and serum levels of 25-D and 1, 25-D were evaluated by spearman's rank correlation analysis.Results： The expression of VDR mRNA was significantly higher in AS group than that in control group (P ＜0.01).There was no significant correlation between expression of VDR mRNA and disease activity (BASDAI, ESR and CRP) (P ＞0.05).The concentrations of 25-D and 1, 25-D were in AS group were significantly lower than those in healthy controls [(5.3 ±2.6) (μg/ L vs( 14.7 ±3.5)μg/L and( 12.8 ±6.0)ng/L vs(32.6 ± 18.5)ng/L, P ＜0.01].In AS group, significant negative correlations were found between 1, 25-D and BASDAI (r = -0.481, P ＜0.05 ) , ESR (r = -0.535, P ＜ 0.01) and CRP (r= -0.674, P ＜0.01).However, there was no significant correlation was revealed between serum 25-D level and BASDAI, ESR or CRP in patients with AS (P＞0.05).Conclusion： Increased expression of VDR mRNA in AS patients has no correlation with the disease activity.The reduction of 25-D and 1, 25-D negatively correlated with disease activity of AS.Thus serum level of 1, 25-Dihydroxy vitamin D can be used as an indicator for disease activity of AS.The VDR activation may not relate to 1, 25-D.%目的:研究AS 患者PBMC维生素D受体(VDR) mRNA的表达及血清25-羟维生素D3和1,25-二羟维生素D3的水平,探讨其与AS疾病活动性(BASDAI、CRP、ESR)的相关性.方法:选取26例AS患者(AS组)和年龄、性别与之相匹配的13名健康志愿者 (健康对照组).采用SYBR GreenⅠ实时荧光定量PCR检测两组受检者PBMC的VDR mRNA表达水平,应用ELISA法检测两组受检者血清25-羟维生素D3和1,25-二羟维生素D3水平,分析VDR mRNA表达水平、血清25-羟维生素D3和1,25-二羟维生素D3水平与临床相关指标(BASDAI、CRP、ESR)的关系.结果:AS患者PBMC的VDR mRNA表达水平明显高于健康对照组(P＜0.01),VDR mRNA表达水平与临床相关指标(BASDAI、CRP、ESR)无关 (P＞0.05).AS患者血清25-羟维生素D3、1,25-二羟维生素D3水平分别为(5.3±2.6) μg/L、(12.8±6.0) ng/L,明显低于健康对照组(14.7±3.5) μg/L、(32.6±18.5) ng/L (P均＜0.01).AS患者血清1,25-二羟维生素D3的水平与BASDAI(r=-0.481,P＜0.05)、ESR(r=-0.535,P＜0.01)、CRP(r=-0.674,P＜0.01)均呈负相关.血清25-羟维生素D3水平与BASDAI、CRP、ESR无关 (P＞0.05).结论:AS患者VDR mRNA表达水平升高,但与AS的疾病活动无关.AS患者血清1,25-二羟维生素D3水平下降,与疾病活动呈负相关,可作为AS疾病活动的指标之一.AS患者PBMC的VDR活化可能与1,25-二羟维生素D3的作用无关.
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