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目的:通过研究系统性红斑狼疮和类风湿关节炎患者血浆IL-17A水平和外周血单核细胞RORrt基因表达状态研究IL-17A与自身免疫性疾病的发病机制的关系。方法:分别选取初发系统性红斑狼疮患者(SLE组)和类风湿关节炎(RA组)患者为研究对象,同年龄的健康体检者为对照组,通过ELISA法检测各组血浆IL-17A水平,荧光实时定量PCR检测外周血单核细胞RORrt基因表达情况。结果:(1)SLE组和RA组的血浆IL-17A水平和RORrt基因表达显著高于正常对照组(P<0.01)。(2)SLE与RA组间的比较:IL-17A水平SLE组高于RA组,但无统计学意义;RORrt基因表达SLE组高于RA组,差异有统计学意义(P<0.05)。(3)两组患者中均发现血浆IL-17A水平和RORrt基因表达增高相关;多元回归分析显示SLE组血浆IL-17A水平和RORrt基因表达的增高与狼疮活动指数(SLEDAI)相关,RA组血浆IL-17A水平的升高与Hb、ESR、CRP、RORrt基因表达相关。结论:IL-17A和RORrt基因表达增高与系统性红斑狼疮和类风湿关节炎的发生有关,IL-17A的升高参与该类自身免疫性疾病的发生可能与RORrt基因表达的增加有关。
OBJECTIVE: To investigate the relationship between IL-17A and the pathogenesis of autoimmune diseases by studying the plasma levels of IL-17A and RORrt gene in peripheral blood monocytes in patients with systemic lupus erythematosus and rheumatoid arthritis. Methods: The patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) were selected as subjects and the healthy subjects of the same age as control group. The levels of plasma IL-17A Real-time quantitative PCR was used to detect RORrt gene expression in peripheral blood mononuclear cells. Results: (1) Plasma IL-17A level and RORrt gene expression in SLE group and RA group were significantly higher than those in normal control group (P <0.01). (2) Comparison between SLE and RA groups: The level of IL-17A in SLE group was higher than that in RA group, but there was no statistical significance. The expression of RORrt gene in SLE group was higher than that in RA group (P <0.05). (3) The level of plasma IL-17A was correlated with the increase of RORrt gene expression in both groups. Multivariate regression analysis showed that plasma IL-17A level and RORrt gene expression in SLE group were correlated with lupus activity index (SLEDAI) Elevated IL-17A levels are associated with Hb, ESR, CRP and RORrt gene expression. CONCLUSIONS: The increased expression of IL-17A and RORrt genes is associated with the development of systemic lupus erythematosus and rheumatoid arthritis. Elevated IL-17A involvement in this type of autoimmune diseases may be related to the increased expression of RORrt gene.