| Objective: Ankylosing spondylitis is a progressive chronic rheumaticdisease characterized by inflammation of axial skeletal ankylosis andperipheral joints, which mainly involves sites in and around the joints such astendon and synovial. Until now, the pathogenic mechanism of AS is stillunclear, although a lot of data has suggested that immunity, infection andgenetic factor HLA-B27contribute to the pathogenesis in AS. Recent studieshave found that, as a new subset of T helper cells that help B cells, theinduction effect of follicular helper T cells in many rheumatic diseases isextremely important. Thus, there aren’t research reports about the role of Tfhcells in AS now. The aim of this study is to assess the role of Tfh cells bytesting the levels of Tfh cells and cell factor interleukin (IL)-2l, CXCL13inthe peripheral blood of AS.Methods:34cases of AS patients who come from the Third Hospital ofHebei Medical University were collected during October2012to March2013.The classification of all AS patients were consistent with New York criteriamodified in1984. Those patients included26who had positive HLA-B27, and8negative.26cases of AS patients with peripheral joint involvement (mainlyrefers to the hip joint) were called periphery group and the others were calledaxis group. All the selected patients with AS were not treated by hormone orimmunosuppressant before3months, and by non-steroidal anti-inflammatorydrugs before2weeks.24cases of health controls from Health Examin-ation Center of the Third Hospital of Hebei Medical University were collected.The Tfh cells were obtained from patients and normal controls and detected byFlow cytometry. While the levels of IL-21and CXCL13were measured byavidin biotin peroxidase complex enzyme-linked immunosorbent assay (ABC-ELISA) in all cases. And the differences of Tfh, IL-21and CXCL13between AS with peripheral joint involvement and AS with non-perip-heral joint involvement, AS with positive HLA-B27and AS with negativeHLA-B27were analyzed. The laboratory parameters of AS patients wererecorded such as ESR, CRP and BASDAI. The correlations were analyzedbetween Tfh, IL-21, CXCL13and clinical parameters.All the data were analyzed by statistical software SPSS13.0for windows.The mean number±standard deviation (x±s) was used to express the measure-ement data. The t test or rank sum test was adopted for comparison betweengroups. Spearman rank correlation analysis was performed for correlationship.P value<0.05was considered significant.Results:1General data description of AS group and control groups: The studygroup comprised34AS patients (27men and7women). The mean age was31.24±8.42years (range20to56years). The mean median duration was90months (range3months to40years). The normal control comprised24subjects (19men and5women). The mean age was27.79±4.04years (range23to41years). There were no differences between the AS group and controlgroup in age and gender (P>0.05).2The level of Tfh in AS group and control group: The expression of Tfhcells in the peripheral blood of AS (mean rank33.71) was significantly higherthan normal controls (mean rank23.54)(P=0.024).3The levels of IL-21, CXCL13of AS group and control group: The levelof IL-21in AS group was (299.13±27.44) ng/L, which was significantlyhigher than normal controls (176.25±25.76) ng/L (P=0.000). The level ofCXCL13in AS group was (5.83±1.02) ug/L, which was significantly higherthan normal controls (4.24±0.75) ug/L (P=0.000).4The levels of Tfh, IL-21and CXCL13in AS of peripheral jointinvolvement and AS of non-peripheral joint involvement: It was similar in ASof peripheral joint involvement compared with AS of non-peripheral jointinvolvement. Mean rank of Tfh were16.77and19.88(P=0.440). Concentration of IL-21were (300.73±27.90) ng/L and (293.92±26.99) ng/L(P=0.548). Concentration of CXCL13were (5.78±1.04) ug/L and (5.97±0.99)(P=0.658).5The levels of Tfh, IL-21and CXCL13in AS with positive HLA-B27and AS with negative HLA-B27: There was no differences between AS withpositive HLA-B27and AS with negative HLA-B27. Mean rank of Tfh were17.04and19.00(P=0.626). Concentration of IL-21were (300.84±28.30) ng/Land (293.55±25.36) ng/L (P=0.519). Concentration of CXCL13were(5.84±1.02) ug/L and (5.80±1.08)(P=0.923).6The correlation analysis: No correlation was found in AS between theexpression of Tfh, IL-2l, CXCL13and levels of ESR (r=-0.285, P=0.102;r=-0.008, P=0.963; r=-0.018, P=0.920), CRP (r=-0.210, P=0.234; r=0.061,P=0.732; r=0.100, P=0.573), BASDAI (r=-0.249, P=0.156; r=0.089, P=0.619;r=0.077, P=0.665). There was no significant correlation between theexpression of Tfh, IL-2l, CXCL13and levels of ESR, CRP, BASDAI in AS ofperipheral joint involvement or AS of non-peripheral joint involvement(P>0.05). And there was no significant correlation between the expression ofTfh and IL-2l (r=-0.092, P=0.606), CXCL13(r=0.136, P=0.444).Conclusions:1The expression of Tfh and the levels of IL-21, CXCL13are increasedsignificantly. These results indicate that the abnormality of Tfh may play animportant role in the pathogenesis of AS.2We can’t find that the expression of Tfh and the levels of IL-21,CXCL13are related to involved place and HLA-B27.3We can’t find that the expression of Tfh and the levels of IL-21,CXCL13are related to disease activity. |
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