类风湿关节炎与白细胞介素-18 的研究进展

类风湿关节炎发病机制不明,许多细胞因子参与了RA的发病机制。近年发现,白细胞介素-18可作用于RA发病的多个参与因素,成为研究RA的新热点。     

类风湿关节炎患者抗CCP，RF，AKA，ASO，RA33的临床价值分析

目的:分析抗抗环瓜氨酸肽(CCP)、类风湿因子(RF)、抗角蛋白抗体(AKA)、抗链球菌溶血素"O"(ASO、)抗RA33抗体对类风湿关节炎诊断的临床价值。方法:选取2015年3月至2016年2月本院收治的79例类风湿关节炎患者视为观察组,另选取同期本院收治的85例非类风湿关节炎自身免疫疾病者视为对照组。比较类风湿关节炎和非类风湿关节炎患者抗CCP、RF、AKA、ASO、RA33阳性情况,对抗CCP、RF、AKA、ASO、RA33的特异度和敏感度予以分析。结果:两组患者的ASO阳性率比较无显著性差异(P0.05),观察组的抗CCP、RF、AKA、RA33阳性率显著高于对照组(P0.05)。抗CCP抗体诊断类风湿关节炎患者的敏感度为64.56%、特异度为92.94%;RF敏感度为60.46%、特异度为80.00%;AKA敏感度为51.90%、特异度为96.47%;ASO敏感度为10.13%、特异度为89.41%;抗RA33抗体敏感度为30.38%、特异度为95.29%。结论:抗CCP、RF、AKA、RA33对类风湿关节炎患者均具有较高的诊断价值,而ASO在类风湿关节炎患者中的诊断价值不明显。     

多模态超声在类风湿关节炎动物模型中的应用进展

类风湿关节炎(rheumatoid arthritis, RA)是以滑膜炎为主要特征的慢性自身免疫性疾病,可导致关节畸形及功能障碍。RA动物模型能很好地模拟疾病发生发展的病理生理过程,广泛用于RA实验研究。多模态超声技术可以定性、定量诊断RA,监测病情变化,评估药物疗效,引导局部给药及靶向治疗,为RA动物模型研究提供精准方法。该文综述了多模态超声在RA动物模型诊疗中的应用情况。     

类风湿关节炎的生物标志物

类风湿关节炎(rheumatoid arthritis, RA)是一种病因未明且以炎性滑膜炎为主的慢性系统性疾病,产生大量的自身抗体,导致不可逆的关节损伤,并引起严重的关节外症状和并发症。因此早期识别具有侵袭性的RA以便及时诊断和治疗对预防RA进展有重要作用。其中,生物标志物是用于诊断RA、评估炎症程度和疗效的有用工具。本文结合国内外研究对RA特异性诊断的生物标志物以及疾病活动性生物标志物进行综述,对近年来RA生物标志物的研究进展作一阐述。     

基于无菌动物研究肠道微生物与类风湿关节炎发病相关性

肠道微生物与宿主的生长发育、免疫、代谢等方面均密切相关,但肠道菌群与宿主之间复杂的相互作用在很大程度上仍然是未知的。目前无菌动物已成为探索肠道微生物与宿主相互作用的重要工具,多项研究使用无菌动物模型探讨肠道菌群在宿主代谢、机体免疫系统的发育和成熟等方面的作用,其中包括肠道菌群在自身免疫性疾病发病及预后中的作用。研究发现,肠道菌群作为环境因素之一可能参与类风湿关节炎(rheumatoid arthritis,RA)发病,然而其因果关系未明。本文将对使用无菌动物探讨肠道微生物参与类风湿关节炎发病的相关性研究作一综述,为进一步深入研究肠道菌群在RA发病中的作用及机制研究提供理论依据。     

靶定IL-17 治疗类风湿关节炎研究进展

IL-17作为前炎症因子参与类风湿关节炎,系统性红斑狼疮等自身免疫性疾病的病理过程。它主要由CD4+T细胞的一个亚群--Th17细胞分泌释放。目前,IL-17在类风湿关节炎的病理过程中的作用引起了医学界广泛的关注,抗IL-17A抗体已经生产并进入临床实验,用于治疗类风湿关节炎、银屑病关节炎等疾病。但其在类风湿关节炎病理过程中的作用尚需进一步研究,其有效性亦尚需进一步探讨。本文主要针对IL-17家族的各个亚型的表达、调控、生物学作用及与类风湿关节炎发病的关系进行阐述,为类风湿关节炎的治疗提供新的思路。     

菌群变化对类风湿关节炎的影响

目前,对于类风湿关节炎(rheumatoid arthritis,RA)发病机制的研究虽然并不完全清晰,但过去20多年的研究已经使我们对RA的了解增加了很多。遗传因素对RA有很大的影响,但不足以完全解释RA的发生。随着对菌群与RA关系的了解增多,使我们认识到可以利用调节人体菌群的方法,来改善宿主黏膜及更远处的免疫环境以改善RA。目前研究已表明,RA与多个部位的菌群都有一定的关系。本研究将以RA的发病机制与影响因素为基础,对人体口腔、肺部和肠道的菌群变化对类风湿关节炎的影响以及益生菌的治疗作用进行综述。     

雷公藤治疗类风湿关节炎

雷公藤有黄藤木、断肠草、蒸龙草、震龙根等别称,具有祛风除湿、活血通络、消肿止痛的作用。雷公藤作为治疗类风湿关节炎常用药的历史源远流长。类风湿关节炎(rheumatoid arthritis,RA)是一种自身免疫病,以侵蚀性关节炎为主要特征,其病理基础是滑膜炎,主要表现为关节肿胀和疼痛。本文先分别叙述雷公藤和类风湿,最后对近年来雷公藤治疗类风湿的临床研究和作用机制进行综述,以期为临床治疗RA的提供理论参考。     

TNF—α和RANKL与类风湿关节炎的研究进展

类风湿关节炎（RA）是一种以慢性侵蚀性关节炎为特征的自身免疫性疾病,伴随有慢性滑膜炎症及继发的关节软骨和骨质的破坏。肿瘤坏死因子超家族（TNFSF）的成员,特别是肿瘤坏死因子-α／（TNF—α）和核因子-κB受体活化因子配体（RANKL）在疾病的炎症和骨破坏过程中发挥着至关重要的作用。一些靶向于TNFSF的生物制剂已被开发应用于RA的治疗。综述了TNF—α和RANKL在类风湿关节炎中的作用以及靶向药物的治疗效果。     

A second susceptibility gene for developing rheumatoid arthritis in the human MHC is localized within a 70-kb interval telomeric of the TNF genes in the HLA class III region

Rheumatoid arthritis (RA) is a chronic inflammatory joint disease with a multifactorial genetic basis. However, pathogenic genes for RA other than the human leukocyte antigen (HLA)-DRB1 gene have yet to be identified. Here, we investigated whether there is a second susceptibility locus for RA within the human major histocompatibility complex using 18 microsatellite markers distributed from the centromeric (HSET) to the telomeric end (P5-15) of the 3.6-Mb HLA region. Statistical studies of associated alleles on each microsatellite locus showed that one pathogenic gene for RA in the HLA region is localized in the DRB1 gene, as expected. Further, a second susceptibility gene of RA was suggested to be present in the HLA class III region, narrowed to 70 kb, that is just telomeric of the TNF gene cluster (TNFA and LTA) and that is located between the microsatellites TNFa and C1-2-A. In this critical segment, four expressed genes have been thus far identified, NFKBIL1 (IkappaBL), ATP6G, BAT1, and MICB, all of which are candidate genes for determining susceptibility to RA. These results exclude the possibility of involvement of the TNFA genes (TNF-alpha) in the development of RA, which was suggested previously to be a strong candidate for RA in the class III region.     

Genetic and molecular basis of quantitative trait loci of arthritis in rat: genes and polymorphisms

Rheumatoid arthritis (RA) is an autoimmune disease, the pathogenesis of which is affected by multiple genetic and environmental factors. To understand the genetic and molecular basis of RA, a large number of quantitative trait loci (QTL) that regulate experimental autoimmune arthritis have been identified using various rat models for RA. However, identifying the particular responsible genes within these QTL remains a major challenge. Using currently available genome data and gene annotation information, we systematically examined RA-associated genes and polymorphisms within and outside QTL over the whole rat genome. By the whole genome analysis of genes and polymorphisms, we found that there are significantly more RA-associated genes in QTL regions as contrasted with non-QTL regions. Further experimental studies are necessary to determine whether these known RA-associated genes or polymorphisms are genetic components causing the QTL effect.     

Mining functional gene modules linked with rheumatoid arthritis using a SNP-SNP network

The identification of functional gene modules that are derived from integration of information from different types of networks is a powerful strategy for interpreting the etiology of complex diseases such as rheumatoid arthritis (RA). Genetic variants are known to increase the risk of developing RA. Here, a novel method, the construction of a genetic network, was used to mine functional gene modules linked with RA. A polymorphism interaction analy-sis (PIA) algorithm was used to obtain cooperating single nucleotide polymorphisms (SNPs) that contribute to RA disease. The acquired SNP pairs were used to construct a SNP-SNP network. Sub-networks defined by hub SNPs were then extracted and turned into gene modules by mapping SNPs to genes using dbSNP database. We per-formed Gene Ontology (GO) analysis on each gene module, and some GO terms enriched in the gene modules can be used to investigate clustered gene function for better understanding RA pathogenesis. This method was applied to the Genetic Analysis Workshop 15 (GAW 15) RA dataset. The results show that genes involved in func-tional gene modules, such as CD160 (rs744877) and RUNX1 (rs2051179), are especially relevant to RA, which is supported by previous reports. Furthermore, the 43 SNPs involved in the identified gene modules were found to be the best classifiers when used as variables for sample classification.     

鸭疫里默氏杆菌自然转化的发现及机制研究进展

自然转化(natural transformation)是微生物水平基因转移的一种重要机制,其在遗传多样性的产生或修复DNA损伤等方面发挥着重要作用,并且与耐药基因、毒力因子的扩散息息相关。鸭疫里默氏杆菌(Riemerellaanatipestifer,RA)是威克斯菌科中第一个被发现可以发生自然转化的细菌,本文作者利用此特点建立了多种基因编辑的方法,促进了对其遗传多样性和致病机理的研究进程。通过系统性地研究影响鸭疫里默氏杆菌自然转化的因素,鉴定出了参与该菌自然转化的营养物质;通过筛选转座子插入突变体文库,鉴定出了参与该过程的必需基因;最终,在该菌发现了一种新型的自然转化系统。本文结合其他细菌自然转化研究进展,针对以上研究结果进行综述,以期对该菌的自然转化机制有更深入的理解,也为更进一步探明该菌的耐药和毒力基因获得机制提供参考。     

Large-scale gene expression profiles, differentially represented in osteoarthritic synovium of the knee joint using cDNA microarray technology

Osteoarthritis (OA) is one of the most common age-related chronic disorders of articular cartilage, joints and bone tissue. Diagnosis of OA commonly depends on clinical and radiographic findings. However, changes in cartilage associated with the early stage of OA cannot be detected using radiographs, because significant cartilage degeneration must occur before radiographic findings show alterations of the appearance of cartilage. To identify new biomarkers of OA, we analysed gene expression profiles of synovium from 43 patients with OA, ten patients with rheumatoid arthritis (RA), and eight non-OA/non-RA patients using a novel cDNA microarray chip. We identified 21 genes with simultaneous significant differences in expression between OA and non-OA/non-RA groups and between OA and RA groups. Linear discriminant analysis showed that the three groups could be well separated using those 21 genes. Statistical analysis also revealed that several of the 21 genes were associated with disease progression and clinical presentation. The graphical modelling method indicated that some of the 21 genes are significantly associated with a particular clinical presentation, suggesting biological relationships among those genes. This is the first report of the use of cDNA microarray technology to create large-scale gene expression profiles differentially expressed in situ in OA synovium of the knee joint.     

Genetics of rheumatoid arthritis: what have we learned?

Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting 0.5–1% of the population worldwide. The disease has a heterogeneous character, including clinical subsets of anti-citrullinated protein antibody (ACPA)-positive and APCA-negative disease. Although the pathogenesis of RA is poorly understood, progress has been made in identifying genetic factors that contribute to the disease. The most important genetic risk factor for RA is found in the human leukocyte antigen (HLA) locus. In particular, the HLA molecules carrying the amino acid sequence QKRAA, QRRAA, or RRRAA at positions 70–74 of the DRβ1 chain are associated with the disease. The HLA molecules carrying these “shared epitope” sequences only predispose for ACPA-positive disease. More than two decades after the discovery of HLA-DRB1 as a genetic risk factor, the second genetic risk factor for RA was identified in 2003. The introduction of new techniques, such as methods to perform genome-wide association has led to the identification of more than 20 additional genetic risk factors within the last 4 years, with most of these factors being located near genes implicated in immunological pathways. These findings underscore the role of the immune system in RA pathogenesis and may provide valuable insight into the specific pathways that cause RA.     

Cystic fibrosis transmembrane conductance regulator and the etiology and pathogenesis of cystic fibrosis.

Cystic fibrosis (CF) is an inherited disorder causing pancreatic, pulmonary, and sinus disease in children and young adults. Abnormal viscosity of mucous secretions is a hallmark of the disease, and is believed to be the result of altered electrolyte transport across epithelial cell membranes. The monogenic etiology of this disease has been apparent for more than 40 years, but the defective gene has only recently been identified. This was made possible because of a revolution in genetic technology, called positional cloning, which can pinpoint disease genes without previous knowledge of the abnormal protein product. The protein encoded by the gene defective in CF has been termed the CF transmembrane conductance regulator (CFTR) because of its postulated role in electrolyte transport. Studies investigating the normal function of CFTR and how mutations affect that function, thereby causing CF, have required the combined skills of clinicians, geneticists, molecular biologists, and physiologists. From this collaborative effort a greater understanding of the pathogenesis of this disorder is now emerging. It may soon be possible to introduce novel therapies derived from this new knowledge that will be aimed directly at the basic defect. An ever-increasing number of genes of unknown function will be identified by continuing advances in molecular genetic technology and the advent of the genome sequencing project. The experience in cystic fibrosis research may prove to be a paradigm for investigation of the function of genes isolated by positional cloning methods.