The Level Of Serum Hepcidin And Interleukin 33 In Patients With Rheumatoid Arthritis

BackgroundRheumatoid arthritis(RA)is a common chronic autoimmune disease with the main symptoms of chronic inflammation and hyperplasia of joints and synovium.Anemia is the most common extra-articular manifestation of RA,and anemia of chronic disease(ACD)is the most common type.Anemia associated with RA were mild,moderate anemia,No patients with severe and very severe anemia]1[.Serum hepcidin(Hepc)is a protein that links inflammatory factors and iron metabolism.Hepc25]2[is mainly present in the body and regulates iron metabolism through the release and absorption of iron in the body.Hepcidin regulation of iron simultaneously by both horizontal and inflammatory factors,involved in the immune regulation of inflammatory processes]4,3[.Interleukin-6 is considered as a regulatory factor of Hepc,which can promote the expression of Hepc]6,5[.Interleukin-33(IL-33),a cytokine of the interleukin-1 family,has potent pro-inflammatory effects and regulates Th2 cell responses as well as stimulates mast cells to produce inflammatory cytokines that contribute to arthritis]107[-.Some foreign studies have shown that,IL-33 and rheumatoid arthritis pathogenesis and progression of the disease are closely linked]12,11[.In addition,the upstream regulator of Hepc production is IL-6]6[.IL-33 can stimulate mast cells to produce IL-6 and IL-1β,leading to the inflammatory effect and aggravating the inflammatory reaction of the joint.Both play an important role in the pathogenesis of rheumatoid arthritis character.ObjectiveA total of 65 serum samples were collected from healthy volunteers,and serum and clinical data of 138 patients diagnosed as rheumatoid arthritis were collected.Serum hepcidin levels and IL-33 levels were measured in patients with rheumatoid arthritis and in healthy subjects,to investigate the relationship between the both with rheumatoid arthritis.MethodsSerum hepcidin levels and serum IL-33 levels were measured in 138 rheumatoid arthritis patients and 65 healthy subjects by ELISA.We discuss the relationship between serum hepcidin and IL-33 with rheumatoid arthritis respectively,and whether there is a correlation between them.Result1.Serum Hepc levels were 58.97 ± 20.45 ng / ml in RA group,60.23 ± 22.80 ng / ml in RA-ACD group,58.29 ± 19.19 ng / ml in RA without anemia group and 45.95 ± 21.64ng/ ml in control group.RA group was significantly higher than the control group(p<0.001),RA-ACD group and RA without anemia group were significantly higher than the control group(p <0.001)RA-ACD group and RA without anemia group,the difference was not statistically significance of learning.Disease activity score 28 was significantly higher in the RA-ACD group than in the RA without anemia group(p<0.001).Serum Hepc level in RA group was 62.43 ± 19.65 ng / ml,moderate activity was 49.20 ± 18.36 ng / ml and low activity was 26.71 ± 10.79 ng / ml.Hepc levels in highly active stage were significantly higher than those in moderate and low active stage,the difference was statistically significant.There was no significant difference between moderate and low activity stage.The RA-ACD group and the RA without anemia group had a significant difference in disease stage(p <0.05).According to thedegree of anemia group,mild serum Hepc level compared with moderate anemia group was not statistically significant.2.The level of serum IL-33 was 123.27 ± 38.91 pg / ml in RA group and 14.84 ±6.57 pg / ml in control group,which was significantly higher in RA group than in control group(p <0.001).RA-ACD group was 117.31 ± 37.74 pg / ml in RA group and 126.46 ±39.35 pg / ml in RA without anemia group,the difference between the two groups was not statistically significant.The level of serum IL-33 was 127.89 ± 39.18 pg / ml in the high activity period,111.10 ± 32.63 pg / ml in the moderate activity period and 72.17 ±29.17 pg / ml in the low activity period,the high activity was significantly higher than the low activity,the difference was statistically significant between the high acticity and the low acticity,and there was no significant difference between height and moderate activity,moderate and low activity.3.Hepcidin levels in patients with rheumatoid arthritis were positively correlated with interleukin-33 levels(p <0.001).ConclusionSerum hepcidin levels in patients with rheumatoid arthritis were significantly higher than those in healthy subjects,and interleukin-33 levels were significantly higher than those in healthy subjects.Hepcidin and interleukin-33 levels were different among rheumatoid arthritis patients with different disease activity levels,and serum hepcidin levels were positively correlated with disease activity,anti-cyclic citrullinated peptide antibody,and rheumatoid factor.Interleukin 33 levels and disease activity,rheumatoid factor was positively correlated.Serum hepcidin levels in patients with rheumatoid arthritis were positively correlated with interleukin-33 levels.