| Objective: Rheumatoid arthritis (RA) was a autoimmune disease,characterized with symmetric polyarthritis. Recently, many researchers haveobserved that extra-articular organs were highly involved in RA patients. andthe most common extra-articular manifestations was pulmonary involvementbecause it was rich in connective tissue and blood supply. According toresearch, interstitial lung disease (ILD) caused by autoimmune disease wasmost common second ILD, late can progress to interstitial pulmonary fibrosis(IPF) and the prognosis was very poor. In the process of the development ofRA there were a variety of cells and inflammatory cytokines. Vascularendothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) andinterleukin-12(IL-12) may play very important roles in the occurrence anddevelopment of RA and the form of interstitial pulmonary fibrosis (IPF). Theaim of this article was to investigate the mechanism of RA and RA-IPFthrough detecting the serum levels of VEGF, bFGF and IL-12.Methods:63RA patients were studied, including27patients comp-licated with IPF and36patients without IPF. All of these samples wereconsistent with the American College of Rheumatology (ACR)/EuropeanUnion of resistance Rheumatism (EULAR) RA classification standardsrevised in2010, IPF diagnostic reference the standard of the diagnosis of IPFthat put forward by American Thoracic Society/European RespiratorySociety/Japanese Respiratory Society/Latin American Thoracic Associationin2011. Exclusion criteria:(1) complicated with other lung diseases, such aspulmonary infection, pulmonary tuberculosis, chronic obstructive pulmonarydisease, bronchiectasis and pulmonary tumor, etc;(2) pulmonary interstitialdisease caused by pneumoconiosis, inhaled organic matter;(3) chroniccardiopulmonary failure. The serum levels of VEGF, bFGF, IL-12of RA patients were measured through avidin biotin peroxidase complex enzyme-linked immunosorbent assay (ABC-ELISA), and compared with normalcontrols. The clinical data of RA patients were recorded such as erythrocytesedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF)laboratory indexes, calculating the28-joint disease activity scale (DAS28).Correlation analysis were made between the VEGF and bFGF and IL-12andclinical data.All the data were analyzed with SPSS18.0for Windows statisticalsoftware, Quantitative data were expressed as (x±s) when measurement dataconformed to normal distribution, The t or t’ test was adopted for comparisonbetween two groups, the measurement data which did not meet normaldistribution was expressed by median and quartile range (M，QR)，varianceanalysis was performed for multiple samples, and nonparametric test wasperformed for skewed distribution, χ2test was adopted for comparisonbetween groups for numeration data. Linear correlation analysis wasperformed for correlationship. P value<0.05was considered significant.Result：1The description of the basic data：The RA group comprised63patients, including12cases of male,51cases of female, the mean age was(55.37±11.35) years and mean disease duration was (52.81±62.87) months;RA-IPF group were27patients, including8cases of male,19cases of female,the mean age was (60.44±9.00) years and mean disease duration was(69.12±69.91）months; the RA-NIPF group comprised36patients, including4cases of male,32cases of female, the mean age was (51.56±11.54) yearsand mean disease duration was (40.58±52.82) months; control group were20cases, including5cases of male,15cases of female, the mean age was(50.45±9.87) years. There was no significant difference between the controlgroup and RA group in age and gender（P＞0.05）.2The measured results of clinical indicators: RA-IPF group andRA-NIPF were no differences in gender and disease duration (P>0.05),however, the age of RA-IPF group was significant older than RA-NIPFgroup (P <0.05); the RF in RA-IPF group was（359.00，531.00）IU/ml which was significantly higher than RA-NIPF group（148.00，332.10） IU/ml (P<0.05); and the mean CRP, ESR, DAS28in RA-IPF group were（48.78±43.50）mg/L,（63.00±26.34）mm/h,（6.06±1.15）respectively; themean CRP, ESR, DAS28in RA-NIPF group were（41.03±40.72）mg/L,（62.19±32.30）mm/h,（5.81±1.09）. There were no statistical significancebetween RA-IPF and RA-NIPF group in the levels of ESR, CRP, DAS28(P>0.05).3Serological index test results:3.1Comparing RA group with control group: The levels of VEGF, bFGFand IL-12in RA and control group were (461.37±124.86) pg/ml,(32.87±11.07)pg/ml,(33.47±10.01)pg/ml and (148.43±54.79) pg/ml,(17.01±3.39) pg/ml,(21.06±7.75) pg/ml respectively, the levels of RA group were significantlyhigher than normal controls (P <0.05).3.2Compared RA-IPF group with RA-NIPF group and normal controlgroup: The levels of VEGF, bFGF and IL-12in RA-IPF group were(527.97±136.57) pg/ml,(40.48±10.88) pg/ml（,36.39±10.85）pg/ml respective-ely; and in RA-NIPF group were (411.42±88.16) pg/ml,(27.16±7.14) pg/ml,（31.28±8.85）pg/ml respectively; and in control group were (148.43±54.79)pg/ml,(17.01±3.39) pg/ml,(21.06±7.75) pg/ml respectively; The levels ofRA-IPF group were significantly higher than RA-NIPF group (P <0.05) andRA-NIPF group were significantly higher than control group (P <0.05).4The correlation of clinical indicators between VEGF, bFGF and IL-12:There was significant correlation between VEGF with CRP (r=0.541, P=0.000), ESR (r=0.526, P=0.000), RF (r=0.485, P=0.000) and DAS28（r=0.551，P=0.000）and VEGF and no significant correlation with age(r=0.267，P=0.034), duration (r=0.153，P=0.232). There was significantcorrelation between bFGF with RF (r=0.805，P=0.000), and no significantcorrelation with age (r=0.263，P=0.037), duration (r=0.137, P=0.238), CRP(r=0.145，P=0.258), ESR (r=0.285，P=0.024), DAS28（r=0.206，P=0.106）.There was significant correlation between IL-12with age(r=0.324，P=0.009）,ESR（r=0.487，P=0.000）, RF（r=0.691，P=0.000）, DAS28（r=0.555， P=0.000; and no significant correlation with duration（r=0.056，P=0.662）andCRP(r=0.258，P=0.041).5The correlation of indicators between the levels of serum VEGF,bFGF and IL-12: According to linear correlation analysis showed, there weresignificantly positive correlation between VEGF and bFGF （r=0.625，P=0.000）, IL-12and bFGF（r=0.659，P=0.000）,VEGF and IL-12（r=0.591，P=0.000）.Conclusion:1The serum levels of VEGF, bFGF and IL-12in RApatients were significantly increased, suggesting that VEGF, bFGF and IL-12may play important roles in the occurrence and development of RA.2It prompted that VEGF, bFGF and IL-12may play roles in path-ogenesis of RA-IPF, with especially higher levels than RA-NIPF.3The serum levels of VEGF, bFGF and IL-12were associated withactivity of RA, may provide theory evidence to the use of biological agents forRA and RA-IPF. |
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