The Expression And Clinical Significance Of Serum Interleukin- 22, Interleukin- 33 In Rheumatoid Arthritis Associated With Interstitial Lung Disease

ObjectiveIncidence of interstitial lung disease(ILD) in rheumatoid arthritis(RA) is more and more prominent, often onset hidden, at present there is no specific laboratory examination. This paper proposed through the determination of serum interleukin-22(IL- 22), interleukin-33(IL-33) expression level in patients with rheumatoid arthritis associated with interstitial lung disease(RA-ILD), to explore the clinical significance of serum IL- 22, IL-33 in RA-ILD.Methods53 patients diagnosed RA which selected in Longyan First Hospital affiliated to Fujian Medicine University from April 2013 to December 2014 were divided into RA – ILD group(n= 22) and RA group(n= 31). 44 cases with women, aged 36 to 81 years old, 18 were male, aged 27 to 71 years old. All RA patients diagnosed according to the 2009 American College of Rheumatology(ACR) and The European League Against Rheumatism(EULAR) new classification standards and scoring system.At the same time, 30 healthy subjects were chosen as the normal control group, which 8 men and 22 women, aged from 31 to 72 years old. Then collected RA patients general information and related clinical performance, couted DAS28 score, and detected the related clinical laboratory index. The level of serum IL-22,IL-33 in two groups and controls were detected by Luminex liquidchip. Observing and comparison the level of IL-22,IL-33 in groups to analysis the correlation between them. Dynamic observation of the expression of IL- 22 and IL- 33 in RA- ILD group before and after treatment. The Mann- Whitney U Test, Kruskal Wallis H Test(H Test), Nemenyi and Spearman linear correlation analysis were used for statistical analysis.ResultsBefore the treatment, there was no significant difference in two groups(RA and RA-ILD)of patients with age, tender joint count, swollen joint count and erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), DAS28 score and cyclic citrullinated peptide(CCP)(P > 0.05),but rheumatoid facter(RF) serum titer in RA-ILD group was obviously higher than that of RA group, the difference was statistically significant. Before the treatment, the expression of serum IL- 22, IL- 33 in RA group and RA- ILD group were significantly higher than controls(P < 0.01).Compared to the two kinds of cytokines, RA- ILD group increased more obviously. The concentration level of IL-22, IL-33 in RA-ILD patients was positively correlated with rheumatoid facter(RF) and cyclic citrullinated peptide(CCP).There was no significant correlation among ESR, CRP, DAS28. After treatment,the level of serum IL- 22, IL- 33 significantly decreased(P< 0.05).ConclusionIL-22, IL-33 may be involved in the pathogenesis of RA, and play an important role on the pathogenesis of RA- ILD process; the high expression of IL- 22, IL- 33 can be used as important reference indicators to predict the pathogenesis and judge the curative effect of RA- ILD.