B Lymphocyte Stimulator In Rheumatoid Arthritis And Psoriatic Arthritis

[Objective]]To study serous B lymphocyte stimulator(BlyS) level in patients with rheumatoid arthritis(RA) and psoriatic arthritis(PsA).To find the differences level of B lymphocyte stimulator between serum,synovial fluid and urine in RA patients and the relationship of BlyS with RA disease activity.To explore the role of BlyS in pathogenesis of RA and PsA.To validate the application of DAS28,SDAI and CDAI in Chinese RA patients.[Methods]The clinical data of RA patients during 2005-2009 has been reviewed. ELISA method was applied to detect the BlyS level in 62 serous samples,30 urinary samples and 8 synovial fluid of RA patients,12 serous and urinary samples of PsA patients,also 40 serous samples and 20 urinary samples from healthy controls. Differences of BlyS level between disease activity and remission was analysed to explore the pathogenic role of BlyS in rheumatoid arthritis and psoriatic arthritis. DAS28,SDAI and CDAI methods have been used to evaluate diesase activity of RA patients.[Results]1.The median of BlyS level of serum is 2.414ng/ml in Healthy controls,4.693 ng/ml in PsA patients,17.716ng/ml in patients with rheumatoid arthritis.The rank sum test toα'=0.017(0.05/3) for test standard,Serous BlyS level in RA and PsA patients is higher than in healthy people(P＜0.017);BlyS level is higher in RA patients when compared with PsA(P=0.002＜0.017).2.According to DAS28 criteria,RA patients were individed into remission and activity.BlyS level of patients in avtivity is higher than that of in remission.(P= 0.035).3.Synovial fluid BlyS level is the highest,followed by blood and urine.The level of BlyS in blood and synovial fluid was significantly positive correlated(r=0.82588, P=0.0115).Whereas no correlation was found between that in serum and urine(R =0.12026,P=0.7767). 4.Serous BlyS level is higher than that of urinary samples in PsA and RA patients.(P =0.0156).BlyS level in serum and urine of PsA patients were unrelated(r~2= 0.57315,P=0.0514).No differences of urinary BlyS level was found in PsA,RA and healthy controls.5.The level of serous BlyS is relative to disease activity(r=0.372,p=0.007).6.DAS28,SDAI and CDAI methods have consistent accuracy and validity in clinical application to the Chinese RA patients.[Conclusion]1.Serous BlyS level in RA patients is higher than in PsA patients.Serous BlyS level in RA and PsA patients is higher than in healthy controls.Synovial fluid BlyS level is the highest,followed by serum and urine in RA patients.Serous BlyS level of RA patients in activity was significantly higher than in remission.The level of BlyS was related to disease activity.BlyS may contribute to the pathogenesis of RA and PsA.2. Different RA disease activity assessment methods(DAS28,SDAI,CDAI) has satisfactory consistency and validity in clinical application to our RA patients.