Expression And Clinical Significance Of T Follicular Helper Cells And Interleukin-21 In Patients With Rheumatoid Arthritis In Peripheral Blood And Synovial Fluid

Objective: In this study, the method to be adopted by flow cytometry(FCM) and enzyme-linked immunosorbent assay(ELISA) for detecting CD4 + CXCR5 + T cells and interleukin(IL)-21 in rheumatoid arthritis(RA) patients with peripheral blood mononuclear cells(PBMC) and synovial fluid, explore the follicular helper T cells(Tfh) effect in rheumatoid arthritis pathogenesis..Methods: RA patients and controls(osteoarthritis patients)collected peripheral blood, synovial fluid. Use the flow cytometry to detected the percentage of CD4+CXCR5+T cells phenotype. The level of IL-21 in serum and and the synovial fluid was detected by ELISA.Results: In peripheral blood mononuclear cells the Tfh cells percentage in the active and remission patients with RA(14.15%±2.74%,12.80%±2.15%)were significantly higher than the control group(7.26%±1.62%)(P <0.05). The level of the Tfh cells in the active and remission patients was not significantly different. The level of the IL-21 in the active and remission patients with RA(41.88±15.63pg/ml,37.27±11.44pg/ml)were significantly higher than the control group(22.25±1.18)pg/ml(P <0.05).The level of the IL-21 in the active and remission patients was not significantly different. The Tfh cells percentage in synovial fluid of the active patients with RA(3.15%±1.42%)compared to the control group(2.88%±1.17%) was not significantly different.The level of the IL-21 in synovial fluid of the active patients with RA( 37.92±15.49) pg/ml compared to the control group(34.31±5.15)pg/ml was not significantly different. The level of the Tfh cells and the IL-21 in the patients with RA of peripheral blood were positive correlation with An-CCP,RF.Conclusion: Tfh cells may initiate the pathogenesis of RA, but the activity of the disease is not significantly promoted. The IL-21 may not be the major factor for the initiation of the disease activity.