The Detection Of Aeca,il-17 And Vegf The Study Of Their Correlation In Patients With Rheumatoid Arthritis

[Objective] By detecting plasma levels of interleukin-17 and vascular endothelial growth factor and their dynamic changes, as well as the positive expression of anti-endothelial cell antibodies(AECA) in patients with rheumatoid arthritis,We explore (1) the role of AECA, IL-17 and VEGF in the pathogenesis of RA, reveal their relevance with disease activity; (2) the intrinsic link between AECA, IL-17 and VEGF;(3) the role of AECA, IL-17 and VEGF in blood vessels inflammation and vascular regeneration in RA; (4) the value of AECA, IL-17 and VEGF in the early diagnosis, disease condition observation and prognosis of RA.[Methods]①RA Group:In this study, we collected a total of 86 of cases RA inpatients(aged from 19 to 66,median 40.2,male 33,female 53) in the First and Second Affiliated Hospital of Nanchang University, Chinese Medicine Hospital of Jiangxi Province from June 2005 to December 2008. According to the criteria of American Rheumatism Association (ARA),1987, Evaluatioing RA disease activity with core set of indicators recommended by ARA, of 86 cases,30 was in active stage,56 in remission stage. Other rheumatic diseases, infections, tumors were ruled out in all cases. At the same time, specimens in different stages were collected; orthotopic X-ray film of hands were used to determine the stage of RA. RA is divided toⅠ,Ⅱ,Ⅲ,Ⅳfour stages according to ARA criteria.②OA group:45 cases of OA patients(aged from 13 to 67,median 43.6,male 20,female 25), all cases were primary osteoarthritis according to criteria of American Rheumatism Association (ARA),1986.③Control group:30 cases of healthy people,their age, gender, etc. were matched with that of RA and OA cases.All cases were ruled out rheumatic diseases, infections, cancer, cardiovascular and cerebrovascular diseases.④Plasma levels of IL-17, VEGF in each group were detected by ELISA. Positive rate of AECA in RA patients and titer of AECA in RA patients in active and remission stage were detected by IIF.[Results] (1) Plasma IL-17 and VEGF of RA patients were significantly higher than those of healthy control group (P<0.05); plasma IL-17 and VEGF of RA patients were significantly higher than those of OA group (P<0.05); plasma IL-17 and VEGF of OA patients were higher than those of healthy control group, but there was no significant difference (P> 0.05). (2) Plasma IL-17 and VEGF of RA patients with active stage were significantly higher than those of RA group with remission stage and healthy control group (P<0.01), the difference between RA group with remission and healthy control group was not significant (P> 0.05);(3) Plasma IL-17, VEGF of RA with active stage were positively correlated with duration of the disease, erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), rheumatoid factor (RF) (P<0.01 or P<0.05). (4)The difference between plasma IL-17 and VEGF of AECA-positive RA patients group and AECA-negative group was signifieant (P<0.05); titer of AECA-positive group was positively correlated with plasma IL-17 and VEGF (P<0.01) (5) The difference between plasma IL-17 and VEGF of RA patients with different X-ray stages was statistically significant (P<0.05,P<0.01).[Conclusions] (1) Plasma IL-17 and VEGF of RA patients with active stage are significantly higher than those of RA group with remission stage and healthy control group. Plasma IL-17 of RA patients with active stage is positively correlated with the duration of the disease, ESR, hs-CRP, RF, suggesting that IL-17 has certain relations with onset ant duration of RA, IL-17 and VEGF can be used as one of the indicators in the evaluation of RA disease activity. (2)Plasma IL-17 and VEGF of RA patients are significantly higher than those of healthy controls and OA group. Plasma IL-17 and VEGF of OA are higher than that of healthy control group, but the difference is not significant, indicating that IL-17 and VEGF could serve as a indicators of differential diagnosis of RA and OA. (3) The difference between plasma IL-17 of RA patients with different X-ray stages is statistically significant, indicating IL-17 may be involved in the bone destruction of RA, and plasma IL-17can be used as a complementary reference indicator of X-ray examination in RA patients with joint deformity, cartilage damage. (4) The difference of plasma levels of IL-17 and VEGF between AECA-positive RA patients group and AECA-negative group is significant, suggesting that AECA can form antigen-antibody complex and may be directly or indirectly involved in pathogenesis of vascular disease in RA. titer of AECA-positive group is positively correlated with plasma VEGF, indicating VEGF participates in vascular inflammation in RA. (5) There is a certain inherent relation between AECA, IL-17, VEGF and the pathogenesis and prognosis of RA. The interaction and regulation of AECA, IL-17 and VEGF directly or indirectly involved in the inflammation, angiogenesis and other pathological processes of RA. Dynamic observation of AECA-positive titers and IL-17, VEGF levels can be used as as a reference indicator of clinical bservation disease activity, efficacy determination and prognosis of RA.