IL-15在类风湿关节炎中的作用的研究进展

细胞因子在类风湿关节炎(rheumatoid arthritis,RA)的发病机制中发挥着十分显著的作用。近年来,白细胞介素—15 (interleukin-15,IL-15)在RA中的作用受到研究者广泛关注。最新研究表明,IL-15参与了RA的多个发病环节,在RA的进展中扮演着重要的角色。     

类风湿关节炎免疫发病机制研究进展

类风湿关节炎(Rheumatoid Arthritis,RA)是以关节滑膜慢性炎症为主的自身免疫性疾病,其病因及发病机制尚未完全明确。本文从T细胞、树突状细胞、肥大细胞等免疫细胞及IL-1家族、结合含γc受体的细胞因子、IL-12家族、IL-17等细胞因子与类风湿关节炎发生发展的关系阐述类风湿关节炎免疫发病机制有关研究进展。     

细胞因子在类风湿关节炎发病机制中的作用

机体的免疫细胞和非免疫细胞合成和分泌的小分子多肽类因子统称为细胞因子。随着对类风湿关节炎（RA）的病因及发病机制的深入研究,发现细胞因子在RA发病过程中起重要作用。简要综述了细胞因子在RA发病中的促炎、抗炎作用,及细胞因子间的相互作用。     

不同RF型类风湿性关节炎患者Th17相关细胞因子表达研究

目的:探讨类风湿因子阳性与阴性类风湿关节炎(rheumatoid arthritis,RA)患者外周血中辅助T细胞(Th17)及相关细胞因子白介素17(interleukin,IL-17),白介素6(interleukin,IL-6)表达的差异。方法:收集RA患者51例,根据RF测定分为RF+、RF-组,健康查体者(对照组)20例,采用流式细胞术检测受检者外周血单个核细胞(PBMC)的Th17细胞的百分率;以酶联免疫吸附法(ELISA)检测受检者血浆中IL-17,IL-6的水平。结果:RA患者CD4+IL-17+T细胞,IL-17、IL-6水平均高于对照组,RF因子阳性与阴性RA患者之间CD4+IL-17+T细胞,IL-17、IL-6表达水平均存在差异有统计学意义。结论:在RA中不同RF型免疫反应和炎症表达的不同,可能与Th17及相关细胞因子表达差异有关。     

不同RF型类风湿性关节炎患者Th17相关细胞因子表达研究

目的：探讨类风湿因子阳性与阴性类风湿关节炎（rheumatoid arthritis,RA）患者外周血中辅助T细胞（Th17）及相关细胞因子白介素17（interleukin,IL-17）,白介素6（interleukin,IL-6）表达的差异。方法：收集RA患者51例,根据RF测定分为RF＋、RF-组,健康查体者（对照组）20例,采用流式细胞术检测受检者外周血单个核细胞（PBMC）的Th17细胞的百分率;以酶联免疫吸附法（ELISA）检测受检者血浆中IL-17,IL-6的水平。结果：RA患者CD4＋IL-17＋T细胞,IL-17、IL-6水平均高于对照组,RF因子阳性与阴性RA患者之间CD4＋IL-17＋T细胞,IL-17、IL-6表达水平均存在差异有统计学意义。结论：在RA中不同RF型免疫反应和炎症表达的不同,可能与Th17及相关细胞因子表达差异有关。     

类风湿性关节炎患者血清GM-CSF, IL-6, TNF-α水平的变化及其临床意义

目的:通过检测类风湿性关节炎(RA)患者血清粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,探讨其用于RA诊断与预后判断的临床意义。方法:选取我院2013年6月~2016年12月收治的126例RA患者为RA组,并根据病情严重程度分为活动期RA组(69例)和缓解期RA组(57例)两个亚组;另选取同期于我院体检中心接受体检的55例健康体检者为对照组。采用酶联免疫吸附法(ELISA)检测所有对象的血清GM-CSF、IL-6、TNF-α水平。记录比较各组血清细胞因子水平,并分析RA组患者各细胞因子水平及DAS28间的相关性。结果:活动期RA组的血清GM-CSF、IL-6、TNF-α水平均显著高于缓解期RA组和对照组(P0.01),缓解期RA组的血清GM-CSF、IL-6、TNF-α水平亦均显著高于对照组(P0.01)。血清GM-CSF、IL-6及TNF-α水平三者间均呈显著正相关(P0.01);DAS28与血清GM-CSF、IL-6、TNF-α水平亦均呈显著正相关(r=0.473、0.584、0.675,P均0.01)。结论:类风湿性关节炎患者的血清GM-CSF、IL-6、TNF-α水平均显著上调,且与类风湿性关节炎的活动性呈显著正相关,通过检测此类细胞因子对类风湿性关节炎的早期诊断、病情评估及判断预后均具有重要临床意义。     

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。     

中药芪龙风湿丸对类风湿关节炎患者外周血细胞因子IL-1,IL-6,TNF-α的影响

目的采用中药为主的方法治疗类风湿性关节炎(RA),并进行患者外周血细胞因子(CK)的测定及观察治疗前后的变化。方法随机选择RA病人62例,其中治疗组42例以中药益气养阴,甘润辛通法为主自拟中药芪龙风湿丸治疗,同时予MTX每周5 mg,连服60天;对照组20例,予MTX每周5 mg,连续服用60天。同时观察药物对患者外周血细胞因子IL-1,IL-6,TNF-α的影响。结果两组外周血细胞因子治疗前均有异常表达,治疗后异常水平均有下降,中药组治疗前后自身比较,三种细胞因子的下调均有非常显著意义(P<0.01)。与对照组比较,治疗后中药组IL-1,TNF-α的下降有显著意义(P<0.05)。结论以益气养阴,甘润辛通法治疗RA,能改善外周血异常细胞因子表达,对RA病人临床症状和实验室指标均有一定改善作用。     

白介素 31 及其受体

白介素31(IL-31)是一种新型T细胞衍生的细胞因子,其功能受体复合物是由IL-31RA／GPL／GLM-R和OSMR组成的异二聚体。它们在过敏性和非过敏性疾病中起重要作用。     

Th1、Th2和Th17型细胞在类风湿性关节炎和系统性红斑狼疮中的活化特点

探讨Th1、Th2和Th17型细胞在类风湿性关节炎(RA)和系统性红斑狼疮(SLE)发病机制中的作用。收集37例RA患者、25例SLE患者和34例健康人的抗凝血,应用ELISA检测血清中IFN-γ、IL-10和IL-17的水平。与健康对照组比较,RA和SLE患者血清中IFN-γ的水平均具有统计学意义(P<0.05);SLE患者IL-10水平出现有意义的升高(P<0.05);而RA患者IL-17的升高具有统计学意义(P<0.05)。由此提示Th1、Th2和Th17细胞在自身免疫性疾病中均发挥不同的重要作用。     

Interleukin-34 as a promising clinical biomarker and therapeutic target for inflammatory arthritis

Interleukin-34 (IL-34), recently identified as a novel inflammatory cytokine and the second ligand for colony-stimulating factor-1 receptor, is known to play regulatory roles in the development, maintenance, and function of mononuclear phagocyte lineage cells – especially osteoclasts. Regarding its primary effect on osteoclasts, IL-34 has been shown to stimulate formation and activation of osteoclasts, which in turn magnifies osteoclasts-resorbing activity. In addition to its role in osteoclastogenesis, IL-34 has been implicated in inflammation of synovium via augmenting production of inflammatory mediators, in which altered IL-34 expression is regulated by pro-inflammatory cytokines responsible for cartilage degradation. Indeed, IL-34 has been documented to be highly expressed in inflamed synovium of rheumatoid arthritis (RA) and knee osteoarthritis (OA) patients, which are recognized as inflammatory arthritis. Furthermore, a number of clinical studies demonstrated that IL-34 levels were significantly increased in the circulation and synovial fluid of patients with RA and knee OA. Its levels were also found to be positively associated with disease severity – especially radiographic severity of both RA and knee OA patients. Interestingly, emerging evidence has accumulated that functional blockage of IL-34 with specific antibody can alleviate the severity of inflammatory arthritis. It is therefore reasonable to speculate that IL-34 may be developed as a potential biomarker and a new therapeutic candidate for inflammatory arthritis. To date, there are numerous studies showing IL-34 involvement and association with many aspects of inflammatory arthritis. Herein, this review aimed to summarize the recent findings regarding regulatory role of IL-34 in synovial inflammation-mediated cartilage destruction and update the current comprehensive knowledge on usefulness of IL-34-based treatment in inflammatory arthritis – particularly RA and knee OA.     

The role of T-cell interleukin-17 in conducting destructive arthritis: lessons from animal models

Interleukin-17 (IL-17) is a T cell cytokine spontaneously produced by cultures of rheumatoid arthritis (RA) synovial membranes. High levels have been detected in the synovial fluid of patients with RA. The trigger for IL-17 is not fully identified; however, IL-23 promotes the production of IL-17 and a strong correlation between IL-15 and IL-17 levels in synovial fluid has been observed. IL-17 is a potent inducer of various cytokines such as tumor necrosis factor (TNF)-alpha, IL-1, and receptor activator of NF-kappaB ligand (RANKL). Additive or even synergistic effects with IL-1 and TNF-alpha in inducing cytokine expression and joint damage have been shown in vitro and in vivo. This review describes the role of IL-17 in the pathogenesis of destructive arthritis with a major focus on studies in vivo in arthritis models. From these studies in vivo it can be concluded that IL-17 becomes significant when T cells are a major element of the arthritis process. Moreover, IL-17 has the capacity to induce joint destruction in an IL-1-independent manner and can bypass TNF-dependent arthritis. Anti-IL-17 cytokine therapy is of interest as an additional new anti-rheumatic strategy for RA, in particular in situations in which elevated IL-17 might attenuate the response to anti-TNF/anti-IL-1 therapy.     

The role of interleukin-17 in mediating joint destruction in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, persistent inflammatory joint disease with systemic involvement that affects about 1% of the world’s population, that ultimately leads to the progressive destruction of joint. Effective medical treatment for joint destruction in RA is lacking because the knowledge about molecular mechanisms leading to joint destruction are incompletely understood. It has been confirmed that cytokine-mediated immunity plays a crucial role in the pathogenesis of various autoimmune diseases including RA. Recently, IL-17 was identified, which production by Th17 cells. IL-17 has proinflammatory properties and may promote bone and joint damage through induction of matrix metalloproteinases and osteoclasts. In mice, intra-articular injection of IL-17 into the knee joint results in joint inflammation and damage. In addition, it has been shown that blocking IL-17/IL-17R signaling is effective in the control of rheumatoid arthritis symptoms and in the prevention of joint destruction. In this article, we will briefly discuss the biological features of IL-17/IL-17R and summarize recent advances on the role of IL-17/IL-17R in the pathogenesis and treatment of joint destruction in RA.     

The role of T cell interleukin-17 in conducting destructive arthritis: lessons from animal models

Interleukin-17 (IL-17) is a T cell cytokine spontaneously produced by cultures of rheumatoid arthritis (RA) synovial membranes. High levels have been detected in the synovial fluid of patients with RA. The trigger for IL-17 is not fully identified; however, IL-23 promotes the production of IL-17 and a strong correlation between IL-15 and IL-17 levels in synovial fluid has been observed. IL-17 is a potent inducer of various cytokines such as tumor necrosis factor (TNF)-α, IL-1, and receptor activator of NF-κB ligand (RANKL). Additive or even synergistic effects with IL-1 and TNF-α in inducing cytokine expression and joint damage have been shown in vitro and in vivo. This review describes the role of IL-17 in the pathogenesis of destructive arthritis with a major focus on studies in vivo in arthritis models. From these studies in vivo it can be concluded that IL-17 becomes significant when T cells are a major element of the arthritis process. Moreover, IL-17 has the capacity to induce joint destruction in an IL-1-independent manner and can bypass TNF-dependent arthritis. Anti-IL-17 cytokine therapy is of interest as an additional new anti-rheumatic strategy for RA, in particular in situations in which elevated IL-17 might attenuate the response to anti-TNF/anti-IL-1 therapy.     

Inflammatory cytokines induced down-regulation of m-calpain mRNA expression in fibroblastic synoviocytes from patients with osteoarthritis and rheumatoid arthritis

Our previous reports revealed that calpain has proteoglycanase activity and exists in synovial fluid in osteoarthritis and rheumatoid arthritis. We examined the effects of cytokines on expression of the calpain-calpastatin system in fibroblastic synoviocytes (FLS). Primary cultures of human FLS from osteoarthritis (OA) and rheumatoid arthritis (RA) patients were stimulated with inflammatory cytokines and the amounts of m-calpain and calpastatin mRNAs expressed were determined by Northern blotting. Northern blots were subjected to computerized densitometer and band intensities were determined. Interleukin-1 (IL-1) down-regulated m-calpain and tissue-type calpastatin mRNA expression in OA and RA FLS. In RA FLS, although IL-6 did not alter m-calpain mRNA expression, IL-1 + tumor necrosis factor (TNF) and IL-1 + transforming growth factor (TGF) down-regulated m-calpain mRNA expression. These results provide new information about the effects of inflammatory cytokines on calpain and calpastatin system in OA and RA pathology.     

Interleukin-23 as a potential therapeutic target for rheumatoid arthritis

Cytokine-mediated immunity plays a crucial role in the pathogenesis of various autoimmune diseases, including rheumatoid arthritis (RA). Increasing evidence has revealed the importance of IL-23, which closely resembles IL-12 structurally and immunologically, in linking innate and adaptive immunity. IL-23, a newly identified heterodimeric pro-inflammatory cytokine, is composed of a p40 subunit in common with IL-12 and a unique p19 subunit. Recent evidence suggests that IL-23, rather than IL-12, is the crucial factor in the pathogenesis of various immune-mediated disorders. In addition, recent studies have explored the role of IL-23 in patients with RA. An elevated expression of IL-23 has been demonstrated in the synovial fibroblasts and plasma of patients with RA. Moreover, an association between IL-23 and IL-23R polymorphisms with susceptibility to RA has been reported. Therefore, the targeting of IL-23 or the IL-23 receptor has been proposed as a potential therapeutic approach for RA. In this review we will discuss the biological features of IL-23, and summarize recent advances in our understanding of the role of IL-23 in the pathogenesis and treatment of RA.     

IL-17 receptor and its functional significance in psoriatic arthritis

To delineate the functional significance of IL-17 Receptor (IL-17RA) and characterize the IL-17 producing T cell (Th17) subpopulation in psoriatic arthritis (PsA). Mononuclear cells from blood and synovial fluid (SF) were obtained from PsA (n=20), rheumatoid arthritis (RA, n=20) and osteoarthritis (OA, n=20) patients. Synoviocytes (FLS) were isolated from the synovium of RA (n=5), PsA (n=5) and OA (n=5) patients. IL-17RA expression in FLS was identified by western blotting (WB) and flowcytometry. T lymphocytes derived from the SF of these patients were studied to identify and phenotype the Th17 cells. The functional significance of IL-17RA was determined by evaluating its regulatory role on the production of proinflammatory cytokines and endopeptidase. IL-17RA expression was found to be significantly higher in FLS of RA (15.7%±4.9) and PsA (4.5%±0.9) in comparison to OA (1.14%±0.9). Western blot analyses showed that the relative intensity (RI) of IL-17RA protein was higher in RA and PsA compared to OA (Fisher exact, P<0.01). A significant enrichment of IL-17-producing CD4+ T cells (7.9%±2.8) was observed in the SF of PsA patients compared to that of OA patients (P<.001). Compared to OA-FLS, recombinant IL-17 induced higher levels of IL-6, IL-8, and MMP-3 production in PsA-FLS. Blockage of IL-17RA with an anti-IL-17RA antibody inhibited the production of IL-6, IL-8, and MMP-3. This is the first report to demonstrate the functional significance of IL-17RA in PsA. Results of this study support the hypothesis that IL-17RA blocking antibodies have the potential to be a therapeutic option for psoriatic arthritis.