Correlation Between IL-22, MMP-7 And TCM Syndrome Types Of Rheumatoid Arthritis Complicated With Interstitial Lung Disease

Objective:To determine the serum concentrations of IL-22 and MMP-7 in patients with RA-ILD,patients with RA alone and healthy people,to analyze the significance of the above indexes in the incidence of RA-ILD,and to further explore the expression differences of these indexes in patients with different syndrome types of RA-ILD,in order to provide some help for clinical diagnosis and treatment.METHODS:Thirty-eight serum samples from RA-ILD patients,aged 27-80 years,including 22 females and 16 males,were collected and divided into 4 groups according to TCM syndrome standard:phlegm and blood stasis obstruction of collaterals,cold and dampness obstruction,deficiency of qi and blood and deficiency of lung and kidney,with 13,10,7 and 8 patients in each group.A total of 17 sera were collected from patients with RA alone,aged 21-78 years,including 6 males and 11 females.There were 10 serum samples from healthy individuals,aged 20-75 years,including 4 males and 6 females.The above sera were collected from patients admitted to the Rheumatology and Immunology Department,Respiratory Department,Outpatient Department and Physical Examination Department of the First Affiliated Hospital of Hunan University of Chinese Medicine from February 2019 to August 2020.Serum concentrations of IL-22 and MMP-7 in each group were detected by enzyme-linked immunosorbent assay(ELISA),and analyzed statistically by analysis of variance and Pearson correlation analysis.Results:1.Differences in the expression of IL-22 and MMP-7 in each group:the expression level of IL-22 in the RA-ILD group and the RA-NILD group was higher than that in the healthy group(P<0.05),and there was no significant difference in the expression degree of IL-22 in the RA-ILD group and the RA-NILD group(P>0.05).The expression of MMP-7 in the RA-ILD group and the RA-NILD group was higher than that in the healthy group,and the expression of MMP-7 in the RA-ILD group was higher than that in the RA-NILD group.2.Relationship between IL-22,MMP-7 and TCM syndromes:The expression of IL-22 in serum of patients with phlegm and blood stasis obstruction syndrome was higher than that of cold and dampness obstruction syndrome,deficiency of qi and blood and deficiency of lung and kidney syndrome(P<0.05),and there was no significant difference in the expression of the latter three syndromes(P>0.05).The expression of MMP-7 in serum of patients with phlegm and blood stasis obstruction of collateral and cold and dampness obstruction was higher than that of deficiency of qi and blood and deficiency of lung and kidney(P<0.05).3.The relationship between IL-22,MMP-7 and the degree of pulmonary involvement:IL-22 had no significant difference in expression among patients with different degrees of pulmonary lesions(P>0.05);MMP-7 was positively correlated with the range of lung lesions,and the larger the range of lung lesions,the higher the serum MMP-7 concentration was(P<0.05).Conclusion:1.The expression level of IL-22 in serum of RA-ILD and RA patients is higher than that of healthy people,but there is no significant difference between RA-ILD and RA patients alone.2.The expression of MMP-7 was increased in the healthy group,the simple RA group and the Ra-ILD group by group,and the serum MM-7 concentration in the patients with Ra-ILD was positively correlated with the range of pulmonary involvement,so it was speculated that MMP-7 was involved in the whole course of the incidence of Ra-ILD,but whether it can be used as a prediction and diagnostic indicator of the disease still needs further study.3.Both IL-22 and MMP-7 showed correlation with some syndromats of RA-ILD.IL-22 was positively correlated with the syndrome of phlegm and blood stasis,while MMP-7 was positively correlated with the syndrome of phlegm and blood stasis and cold and dampness obstruction.Both of them can be considered as reference indexes of TCM dialectics,but they need further verification.