| Objective: B lymphocyte was related to the pathogenesis inflammations of many autoimmune diseases. There were many researches about B lymphocyte in systemic lupus erythematosus (SLE) and primary Sjogren's syndrome (pSS). Rheumatoid arthritis (RA) was considered as an immune associated disease, the knowledge of B lymphocyte in the pathogenesis of RA was limited. During these years, the notion of the role for B cells and antibodies in these diseases had gained support through researches with experimental animal models. The recent use of B cell monoclonal antibody such as Rituximab (anti-CD20) in patients with RA also emphasized the important role of B cells in the pathogenesis of RA. The aim of this study was to investigate the role of B lymphocyte in the pathogenesis of RA through detecting the expression of CD23 and CD19 in peripheral blood and the level of sCD23 in serum and synovial fluid.Methods: Thirty RA patients and twenty healthy controls were chosen. Disease modifying antirheumatic drugs(DMARDs) and biologic agent were never used for the RA patients. The diagnosis of RA patients were consistent with American Rheumatology Academy(ARA) rheumatoid arthritis diagnostic criteria of 1987. Serum was taken from all the patients and normal controls, synovial fluid was taken from patients with RA. RF, ESR, CRP, IgA, IgM, IgG, C3, C4 and clinical symptoms of RA patients were recorded. Enzyme linked immunosorbent assay (ELISA) was used to measure the levels of sCD23 in serum and synovial fluid. Flow cytometric analysis was employed for detecting surface antigen (CD19,CD23) of lymphocytes in peripheral blood. The correlation coefficients and significances were calculated between the percentage of CD23, CD19 and the laboratory parameters of disease activity (ESR, CRP).All the data were analyzed by SPSS16.0 for windows Statistical software. The mean number±standard deviation ( x±s) was used to express the measurement data. The t test was adopted for comparison between groups. Chi-square test was used for the comparison of the enumeration data. Linear correlation was used to in analyse. P value<0.05 was considered significant.Results:1 The demographic details and traditional parameters of disease activity in RA: In the group of 30 patients with RA, the mean disease duration at presentation was (24.57±5.31) months, with a mean age of (31.95±4.72) yr, and 7 subjects were male, 23 subjects were female. In 20 normal controls, with a mean age of (32.41±9.35) yr, 4 subjects were male, 16 subjects were female. There were no differences between the patients and normal subjects in age, gender (P>0.05). In the group of 30 patients with RA, the mean ESR and CRP were (57.75±36.93)mm/h, (52.04±37.81) mg/L.2 The sCD23 levels in serum of RA patients: The sCD23 levels in serum of RA were(0.4544±0.1603)ng/ml, which were significantly higher than normal group (0.2313±0.1141) ng/ml (P<0.01).3 The sCD23 levels in synovial fluid of RA: The sCD23 levels in synovial fluid were(0.7282±0.3011)ng/ml, which were significantly higher than serum (P<0.01).4 The percentage of CD19+cells in peripheral blood lymphocytes of RA group was(10.2360±2.2118)%, which was significantly higher than normal controls(6.8700±1.0517)% (P<0.05); The percentage of CD23+/CD19+cells in peripheral blood lymphocytes of RA group was(5.1355±1.0685)%, which was significantly higher than normal controls (2.1000±0.6519) % (P<0.01).5 The correlation between serum levels of sCD23 and laboratory parameters of disease(RF, ESR, CRP): According to correlation analysis, the sCD23 levels in serum were positively correlated with RF(r=0.567, P<0.01); There were not significant correlation between serum levels of sCD23 and ESR, CRP (P>0.05).6 The positive rate of RA patients of cells surface expression of CD19 and CD23 associated with the laboratory parameters of disease activity(ESR,CRP): According to correlation analysis, the percentage of CD23+/CD19+cells in peripheral blood lymphocytes of RA group was a positive correlation with ESR and CRP(r=0.705,0.587,P<0.05).There was no significant correlation between the percentage of CD19+cells and the laboratory parameters of disease activity (ESR, CRP) (P>0.05).Conclusions: 1 The sCD23 levels in serum significantly increased in patients with RA, and the sCD23 levels in serum were significantly correlated with RF. It suggested that sCD23 as an inflammatory factor might play an important role in the pathogenesis of RA.2 There was higher level of sCD23 in synovial fluid than in serum, which suggested that sCD23 might have relation to pathological changes of synovium of peripheral joint and articular cartilage destructions.3 The surface expression of CD19+ and CD23+/CD19+cells in peripheral blood lymphocytes of RA group was significantly higher than normal group, and it suggested that the overactivated of B lymphocyte might paly a role in the pathogenesis of RA.4 The percentage of CD23+/CD19+cells in peripheral blood lymphocytes of RA group was significantly higher, and had correlation with laboratory parameters of disease activity (ESR, CRP), which could provide reference to the monitoring of pathogenetic conditions of patients with RA.5 The detection of B lymphocyte molecules in serum and peripheral blood might provide theory evidence to the use of biological agents for RA and the development of new drugs.
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