| Objective: Ankylosing spondylitis (AS) is a chronic progressiveinflammatory spondyloarthropathy, which is associated with HLA-B27, andits changes of the basic pathology were enthesitis and synovitis. RheumatoidArthritis (RA), a systemic autoimmune disease, is characterized by chronicdestructive joints, its basic pathological change is synovitis. The pathogenesisof AS and RA are not uncompletely known. The current study shows thatvarious of immune cells and cytokines play roles in the pathogenesis anddevelopment of AS and RA. Interleukin-9(IL-9), mediates JAK/STATsignaling pathway by its receptor IL-9R, is an important cytokine involved inimmune response and immune regulation in autoimmune diseases, and it getsplenty of attention. The aim of this study is to preliminarily explore thecorrelation between IL-9and the process of pathogenesis and disease developof AS and RA, through investigating the levels of IL-9in serum and of jointfluids of patients with AS and RA.Methods: Choose40AS patients and40RA patients in the departmentof Rheumatology of the Third Hospital of Hebei Medical University fromOctober2012to April2013. AS patients corresponded with the modified NewYork criteria in1984for AS; RA patients conformed to the AmericanRheumatism Institute(ACR) and the European League Against Rheumatism(EULAR) rheumatoid arthritis diagnostic criteria of2009. Respectivelychoose24healthy persons as normal control Ⅰ and Ⅱ. Exclusion criteria:patients with other connective tissue diseases; pregnant or lactating women;serious disease complicated with cardiovascular, liver, kidney and bloodsystem; previously received the drugs treatment such as glucocorticoid (GC), biological agents (etanercept, infliximab, adalimumab); Psychiatric patients; inacute and chronic infection; patients with malignant tumor. The clinicalfeature and laboratory index of AS patients were recorded such as course,erythrocyte sedimentation rate (ESR), C reactive protein (CRP), andcalculated the BASDAI score; the clinical data of RA patients were recordedlike course, the number of tender joints, the number of swollen joints, ESR,CRP, rheumatoid factor (RF), anti-cyclic citrullinated peptide (CCP) antibody,and calculated the DAS28score. According to the Bath ankylosing spondylitisactivity index (BASDAI), AS patients were divided into stable group(n=12)and active group (n=28); base on disease activity index(DAS28) reco-mmended by EULAR, RA patients were divided into moderate activitygroup(n=21) and severe activity group(n=19). Avidin biotin peroxidasecomplex enzyme-linked immunosorbent assay (ABC-ELISA) was used todetect levels of serum and joint fluids IL-9in AS and RA patients and healthycontrols, and compared levels of serum IL-9between case group and that ofnormal control. To further analysis the correlation between the levels of serumIL-9and clinical indexes.Statistical software SPSS13.0for windows was used to analyze all data.The measurement data was expressed by the mean number±standard deviation(x±ｓ). The t test and the Wilcoxon test were performed for mean comparison.Linear correlation analysis was adopted for correlationship. P value<0.05wasconsidered statistically significant.Results:1The general data description: AS group included33male cases and7femalecases. The age ranged from19to56years old. The average age was (31±9)years old. The course was1month to40years.The average course was (8.2±8)years. RA group contained7cases of male and33cases of female. The ageranged from16to75years old. The average age was (52±14) years old. Thecourse was1month to20years. The average course was (7.13±6.96) years.The control groupⅠincluded18male cases and6female cases. The ageranged from23to41years old. The average age was (28±4) years old. The control groupⅡincluded5male cases and19female cases. The age rangedfrom18to72years old. The average age was (46±12) years old. AS group:the mean of ESR, CRP, BASDAI were (46.75±36.808)mm/h,(51.84±50.700)mg/L,(4.58±1.011). RA group: the mean of ESR, CRP, DAS28score were(59.88±31.338) mm/h, CRP(48.14±47.615)mg/L,(5.64±1.336).2The levels of IL-9in serum and synovial fluids2.1The levels of serum IL-9in AS group:The levels of serum IL-9with AS were(644.17±96.82)ng/L, which weresignificantly higher than control group Ⅰ(432.26±56.14)ng/L. The levels ofserum IL-9in the activity group(691.34±57.05)ng/L, were significantly higherthan the stable group(534.10±79.78)ng/L. The activity group and stable groupwere significantly higher than control groupⅠ(P=0.000).2.2The correlation between the levels of serum IL-9in AS group and clinicalindexes:The levels of serum IL-9were significantly positively correlated withCRP(r=0.339, P=0.033), ESR(r=0.529, P=0.000), and BASDAI score(r=0.623, P=0.000). There was no obviously correlation between the levels ofserum IL-9and the course(r=0.233, P=0.148).2.3The levels of serum and knee synovial fluids IL-9in RA group:2.3.1The levels of serum IL-9with RA were (676.44±40.04)ng/L, which wereobviously higher than control groupⅡ(421.34±51.87)ng/L. The levels ofserum IL-9in the severe active group(676.44±40.04)ng/L, were obviouslyhigher than the moderate activity group(561.67±44.17)ng/L. The severe activegroup and moderate activity group were obviously higher than control groupⅡ(P=0.000).2.3.2The levels of knee synovial fluids IL-9in RA group(439.81±37.33)ng/L,were obviously lower than the serum levels(616.18±71.48)ng/L,(P=0.000).2.4The correlation between the levels of serum IL-9in RA group and clinicalindexes: There were obviously correlation between the levels of serum IL-9in RAgroup and CRP(r=0.323, P=0.042), ESR (r=0.392, P=0.012), DAS28score(r=0.909, P=0.000), the number of tender joint(r=0.810, P=0.000), the numberof swollen joint(r=0.831, P=0.000), CCP(r=0.437, P=0.048); There were nosignificantly correlation with the course,(r=-0.062, P=0.704),and RF (r=0.220,P=0.211).Conclusions:1High levels of IL-9in AS and RA patients, suggested that IL-9mayplay a role in the pathogenesis of AS and RA.2The levels of serum IL-9in active group with AS were higher than thestable group, and those were obviously correlated with disease activity andclinical markers of inflammation, which suggested that IL-9correlated withthe AS disease activity.3The levels of serum IL-9in RA patients were positively correlated withthe clinical inflammatory markers, and, those in the severe active group weresignificantly higher than the moderate active group, suggesting that IL-9played a proinflammatory role in the inflammatory reaction of RA, andpromoted the progress of the disease.4The levels of knee joint fluids IL-9in RA patients were obviouslylower than the serum, combined with access to relevant literature, suggestingthat IL-9may play a protective role in the failure process of articular cartilagethrough immune regulation on other correlative cytokines. |
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