破骨细胞和骨保护素/细胞核因子-κB受体活化因子配体系统在银屑病关节炎骨质破坏中的作用

摘要

Objective To explore the effect of osteoclasts and osteoprotegerin/receptor activator of nuclear factor-kappa B ligand (OPG/RANKL) system on bone destruction of psoriatic arthritis.Methods The peripheral blood mononuclear cells from 41 psoriatic arthritis (PsA) patients,20 osteoarthritis (OA) patients and 24 healthy controls were cultured to become osteoclasts.After 14 days,cytochemistry method was used to detect tartrate-resistant acid phosphatase (TRAP) expression.At the same time,enzyme-linked immuno sorbent assay (ELISA) was used to measure the levels of serum OPG and RNAKL for all cases.At the same time,the clinical and laboratory examinations of the PsA were collected.Statistical analysis was conducted with one-way ANOVA and Spearman's correlation.Results Significantly higher OC production was observed in the peripheral blood of PsA patients [(17.7±4.8)/view field] than that of the healthy controls [(6.4±1.6)/view field] and OA patients [(6.5±l.6)/view field].The levels of RANKL were significantly higher in PsA patients [(178±38) pg/ml] than those in the other two groups [(32±4) pg/ml and (67±17) pg/ml].There was significant difference between the PsA group with bone destruction and without destruction in the levels of OC and RANKL [(17.6±0.9) /view vs (7.9±1.3) /view and (199±72) pg/ml vs (128±44) pg/ml,P＜0.01].Imaging scores was positively correlated with the levels of OC and RANKL in PsA patients (P＜0.05).Conclusion In PsA,there are significantly more OC and higher RANKL in the peripheral blood than those of the controls.The high levels of OC and RANKL are closely related with bone destruction.OC and RANKL are useful in identifying bone destruction.%目的 探讨银屑病关节炎( PsA)患者体内破骨细胞和骨保护素/细胞核因子-κB受体活化因子配体(OPG/RANKL)系统的水平与骨质破坏的关系.方法 分离41例PsA患者、20例骨关节炎患者及24名健康对照者的外周血单个核细胞诱导生成破骨细胞,采用耐酒石酸酸性磷酸酶染色法进行鉴定.运用酶联免疫吸附试验( ELISA)法测定3组患者血清中的骨保护素和RANKL的水平,同时收集PsA患者的临床实验室资料.采用单因素方差分析和直线回归分析进行统计学处理.结果 PsA组的破骨细胞数目[(17.7±4.8)个,视野]明显多于骨关节炎组[(6.5±1.6)个,视野]和健康对照组[(6.4±1.6)个,视野],差异有统计学意义(P＜0.05).PsA组的RANKL水平[(178±38) pg/ml]明显高于骨关节炎组[( 32±4) pg/ml]和健康对照组[(67±17) pg/ml],差异有统计学意义(P＜0.05).与无骨质破坏的PsA组相比较,破骨细胞和RANKL的水平在有骨质破坏的PsA组中明显增高[(17.6±0.9)个／视野与(7.9±1.3)个／视野和(199±72) pg/ml与(128±44) pg/ml],差异有统计学意义(P＜0.01).PsA患者的影像学评分和破骨细胞、RANKL的水平呈正相关(r=0.83,0.76；P＜0.05).结论 PsA患者外周血中的破骨细胞数目和RANKL水平显著升高,PsA患者体内的破骨细胞和RANKL水平升高与骨质破坏相关密切,提示破骨细胞及RANKL水平的变化可以反映骨质破坏的严重程度.