sCD14在痛风性关节炎患者炎症反应中的变化及其意义

摘要

目的：探讨可溶性白细胞分化抗原14(sCD14)在痛风性关节炎(GA)患者炎症反应中的变化及其意义。方法选取31例急性 GA(AGA)患者、23例非 AGA(NAGA)患者和20名健康对照者(HC),用实时荧光定量聚合酶链反应(qRT-PCR)检测其外周血单个核细胞(PBMCs)中 CD14的 mRNA 表达水平；用酶联免疫吸附法(ELISA)检测各组血浆 sCD14、白介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)蛋白表达水平,用免疫比浊法测定各组血浆 C 反应蛋白(CRP)含量；检测各组白细胞计数(WBC)、嗜中性粒细胞绝对值(GR)、淋巴细胞绝对值(LY)、单核细胞绝对值(MO)等血常规及血尿酸(UA)等指标变化,比较3组指标的差异并分析其与 PBMCs 的 CD14 mRNA 表达及血浆 sCD14表达的相关性。结果AGA 组 PBMCs 中 CD14 mRNA 表达量高于 HC 组(P <0.05)；HC 与 NAGA 组血浆 sCD14蛋白表达低于 AGA 组(P <0.01),且 NAGA 组表达低于 HC 组(P <0.05)；AGA 组 CRP 蛋白水平高于 HC 与 NAGA 组(P <0.01)；AGA、NAGA 组血浆 IL-1β、TNF-α蛋白水平均显著高于 HC 组(P <0.01),且 AGA 组 IL-1β蛋白水平高于NAGA 组(P <0.01)；AGA 组和 NAGA 组 WBC 高于 HC 组(分别 P <0.01,P <0.05)；AGA 组 GR、MO 均高于 HC组(P <0.05),AGA 组 MO 高于 NAGA 组(P <0.05)；AGA 与 NAGA 组 UA 均显著高于 HC 组(P <0.01)。AGA组 PBMCs 的 CD14 mRNA 表达与 IL-1 b呈正相关(rs =0.362,P =0.045)；NAGA 组血浆 sCD14蛋白表达与 GR 呈正相关(rs =0.397,P =0.030)。结论sCD14在 GA 患者的炎症反应中表达异常,提示 sCD14在 GA 患者的炎症反应中可能发挥重要的调控作用。%Objective To study the changes and significance of sCD14 in inflammatory response of patients with gouty arthritis.Methods CD14 mRNA was measured using quantitative real-time PCR in peripheral blood mononuclear cells (PBMCs).The expression of CD14 mRNA in PBMCs was compared between patients with acute gouty arthritis (AGA)(n =31)and non-acute gouty arthritis (NAGA)(n =23)and healthy controls (HC)(n =20).β-actin was selected as the internal control.The protein expressions of sCD14,IL-1βand TNF-αwere measured using enzyme linked immunosorbent assay (ELISA) in patients’ plasma.The protein expression of CRP was measured using immunoturbidimetry in patients’ plasma. Routine blood and blood biochemistry indexes were measured by routine blood analyzer and blood biochemistry analyzer of patients with AGA,NAGA and HC.We analyzed the correlation between CD14 mRNA,sCD14 protein expression and each clinical indicator.Results When compared with that in AGA group,the mRNA expression of CD14 increased significantly in PBMCs of HC patients (P < 0.05 ).When compared with that in HC and NAGA patients,the protein expression of sCD14 increased significantly in the plasma of AGA patients (P <0.01).The protein expression of sCD14 was significantly lower in the plasma of NAGA than in HC (P <0.05).The protein expression of sCD14 increased significantly in the plasma of AGA compared with HC and NAGA (P < 0.01 ).When compared with those in HC,the protein expressions of IL-1β and TNF-α increased significantly in the plasma of AGA and NAGA (P < 0.01 ).When compared with that in NAGA,the protein expression of IL-1βincreased significantly in plasma of AGA (P <0.01). The indexes of WBC increased significantly in AGA compared with HC (P <0.01),and WBC increased significantly in NAGA compared with HC (P <0.05).The indexes of GR and MO increased significantly in AGA compared with HC (P <0.05),and MO increased significantly in AGA compared with NAGA (P < 0.05 ).The indexes of UA increased significantly in AGA and NAGA compared with HC (P <0.01).There was a positive correlation between CD14 mRNA expression and IL-1β in PBMCs in AGA group (r s =0.362,P =0.045).A positive correlation was found between GR and the protein expression of sCD14 in NAGA patients’plasma (r s = 0.397,P = 0.030 ). Conclusion The dysregulated expressions of CD14 mRNA in PBMCs and sCD14 protein in GA show that sCD14 may play a significantly regulatory role in inflammatory reaction.