基质金属蛋白酶与类风湿性关节炎

基质金属蛋白酶(MMPs)是一类能够联合降解细胞外基质的蛋白质家族,目前已发现20多种。生理状态下,MMPs在组织中降解和修复细胞外基质。在类风湿性关节炎(RA)过程中,一系列细胞因子、生长因子以及激素水平的变化引起MMPs水平升高,使得细胞外基质成分发生不可逆降解及关节破坏。由于MMPs在RA发病过程中起着重要作用,进一步研究MMPs与疾病的关系将为RA的预防、诊断及治疗开辟一条新的途径。     

血清基质金属蛋白酶-3与类风湿关节炎的相关性研究

目的 探讨血清基质金属蛋白酶-3（matrix metalloproteinases-3,MMP-3）与类风湿关节炎（rheumatoid arthritis,RA）及其炎症反应的相关性.方法 用免疫比浊法（immunoturbidimetric assays）检测146例RA患者（RA组）及232例非RA人群（对照组）血清MMP-3水平;对两组MMP-3结果进行ROC曲线分析;分析RA患者血清MMP-3与反映RA患者炎症活动程度临床指标的关系.结果 RA组血清MMP-3浓度为170.00±19.36ng/mL,明显高于对照组的47.92±1.98ng/mL,差异有统计学意义（P＜0.001）.血清MMP-3诊断RA的ROC曲线下面积为0.731,取诊断界限值为71.65 ng/mL时,敏感度为58.9％,特异度为88.79％.RA组患者血清MMP-3水平与其他RA诊断以及反应RA炎症反应的指标,如C反应蛋白（C-reaction protein,CRP）、前白蛋白（prealbumin,PA）、血沉（erythrocyte sedimentation rate,ESR）、血小板（platelet）以及白细胞计数（WBC）均具有显著相关性,P值均＜0.001.结论 RA患者血清MMP-3水平显著高于正常入,其水平与反映RA患者炎症活动程度临床指标CRP、PA、ESR、PLT以及WBC具有显著相关性.类风湿性关节炎患者血清MMP-3水平与类风湿性关节炎的炎症活动性有关.     

糖尿病足患者血清基质金属蛋白酶水平变化

目的:分析糖尿病足患者血清基质金属蛋白酶2(MMP-2)、MMP-9总水平和活性水平变化及临床意义。方法:在本院住院的糖尿病足病患者80例作为糖尿病足组(DF组),同期住院无足病糖尿病患者80例为非糖尿病足组(NDF组),年龄、性别匹配的健康人80例作为对照组(CON组)。ELISA法测定各组血清MMP-2和MMP-9总水平,明胶酶谱法检测各组血清MMP-2、MMP-9活性水平。多因素回归分析影响MMP的危险因素。结果:CON、NDF和DF各组血清MMP-2、MMP-9总水平依次升高(P均<0.05)。DF组和NDF组MMP-2活性高于CON组(P均<0.05),DF组和NDF组水平差异无统计学意义(P>0.05);DF组MMP-9活性水平高于CON组和NDF组(P均<0.05)。多元回归分析显示,DF、糖化血红蛋白(HbA1c)、病程和年龄是MMP-9活性升高的危险因素。结论:糖尿病患者血清MMP-2和MMP-9总水平和活性升高,是DF发生和发展的重要因素。     

HMGB1促进类风湿性关节炎滑膜成纤维细胞表达基质金属蛋白酶-13

目的:探讨高迁移率族蛋白1(HMGB1)能否激活类风湿性关节炎滑膜成纤维细胞(RASF)表达基质金属蛋白酶-13(MMP-13)。方法:HMGB1与RASF共孵育后,采用流式细胞术、实时RT-PCR、ELISA分别检测细胞周期和MMP-13的基因表达量以及蛋白表达水平。结果:1μg/ml HMGB1刺激滑膜成纤维细胞3小时,MMP-13 mRNA的表达明显增加;HMGB1刺激滑膜成纤维细胞48小时后MMP-13蛋白分泌增高,并且滑膜成纤维细胞增殖周期速度加快。结论:HMGB1可以激活滑膜成纤维细胞,使其增殖周期速度加快,MMP-13表达增加,提示HMGB1通过作用于滑膜成纤维细胞表达MMP-13加强关节结构破坏。     

基质金属蛋白酶-3基因多态性研究进展

基质金属蛋白酶-3（MMP-3）是MMPs家族中的重要成员之一，可降解细胞外基质中的多种成分，参与组织重构。MMP-3基因存在多态性位点，这些多态性位点会影响MMP-3的表达，从而影响疾病的发生和发展。目前研究发现MMP-3基因多态性可能与肿瘤、冠心病、子宫内膜异位症等多种疾病的发生和发展有关。     

GM-CSF对类风湿性关节炎患者单核细胞合成MMP的影响

观察GM-CSF刺激前后,类风湿性关节炎(RA)患者单核/巨噬细胞基质金属蛋白酶(MMP-2、MMP-9)合成及CD147表达的变化。从RA患者外周血及滑液分离单核细胞。RPMI1640培养液中培养,加入不同剂量的GM-CSF,用明胶酶谱法测定刺激24h、48h、72h后MMP-2、MMP-9的活性。用流式细胞术测定刺激前后细胞表面CD147表达量。GM-CSF刺激后,细胞呈多形性的巨噬细胞样改变,MMP-2,MMP-9合成增加,而且这种刺激作用与GM-CSF的剂量相关,100ng/ml时刺激作用显著高于12.5ng/ml及25ng/ml;而与作用时间无显著相关性;滑液单核细胞MMP-2、MMP-9表达水平高于外周血单核细胞。GM-CSF刺激后,单核细胞表面CD147的表达显著高于刺激前;滑液单核细胞表达量高于外周血。GM-CSF刺激后,RA患者外周血及滑液单核细胞MMP-2、MMP-9表达增加,同时伴随细胞表面CD147表达增加。     

维药买朱尼对骨关节炎大鼠模型关节软骨中基质金属蛋白酶1和基质金属蛋白酶抑制剂1的影响

背景：骨关节炎患者关节软骨的损害与基质金属蛋白酶1和基质金属蛋白酶抑制剂失平衡有关。 目的：观察基质金属蛋白酶1、基质金属蛋白酶抑制剂1在关节软骨中的表达及维药买朱尼对其影响。 方法：将20只SD大鼠采用改良Hulth造模法建立大鼠膝骨关节炎模型,按随机数字表法随机等分为买朱尼组和模型组,建模第2周开始分别灌胃维药买朱尼和生理盐水,连续4周。 结果与结论：相比于模型组,买朱尼组大鼠膝关节软骨退变程度减轻,软骨大体评分及Mankin评分降低(P < 0.05),且膝关节软骨细胞中基质金属蛋白酶1的表达降低,基质金属蛋白酶抑制剂1的表达增加(P < 0.05)。说明维药买朱尼可以通过下调基质金属蛋白酶1的表达水平、上调抑制剂的表达水平,对软骨产生保护作用。     

大肠癌组织中基质金属蛋白酶-2和基质金属蛋白酶-9的表达

目的：探讨大肠癌组织中基质金属蛋白酶－2（MMP－2）和基质金属蛋白酶－9（MMP－9）的表达与临床病理参数之间的关系。方法：应用免疫组织化学S－P法检测87例大肠癌组织中MMP－2和MMP－9的表达情况。结果：87例大肠癌组织中MMP－2和MMP－9的表达阳性率分别为56．3％和55．2％。MMP－2和MMP－9在侵及肌层的阳性表达率明显低于侵及浆膜层，淋巴结转移阳性组高于淋巴结转移阴性组，差异均有显著性（P＜0．05）。Dukes分期中，C、D期中MMP－2和MMP－9的阳性表达率明显高于A、B期（P＜0．05），而与性别、年龄、肿瘤部位、组织学类型和分化程度均无关（P＞0．05）。结论：MMP－2和MMP－9可能在大肠癌浸润转移过程中发挥重要作用。     

急性心肌梗死患者PCI术前后血清基质金属蛋白酶-2与基质金属蛋白酶-9的相关性

目的: 探讨急性心肌梗死(AMI)患者在急诊经皮冠状动脉介入(PCI)术治疗前后血清基质金属蛋白酶-2 (MMP-2)和基质金属蛋白酶-9 (MMP-9)变化的相关性.方法: 应用酶图(SDS-PAGE zymograph)和Western blot的方法检测56例行PCI术治疗的AMI患者及20例冠状动脉造影正常者术前及术后第1~7 天血清中MMP-2和MMP-9的酶活性及蛋白表达水平,并分析MMP-2和MMP-9变化的相关性.结果: AMI患者PCI术前及术后血清MMP-2和MMP-9的酶活性及蛋白表达水平较对照组明显升高(P<0.01),PCI术患者在术后第1天血清MMP-2和MMP-9的酶活性及蛋白表达水平显著升高,并在术后第3天达高峰(P<0.01),第5天开始明显下降(P<0.05).经Spearman相关性分析表明,各组血清MMP-2的酶活性与MMP-9的酶活性呈正相关(P<0.01);各组血清MMP-2的表达水平与MMP-9的表达水平亦呈正相关(P<0.01).结论: 血清MMP-2和MMP-9酶活性及蛋白表达水平的增加可能是AMI患者心肌缺血再灌注损伤的机制之一.MMP-2和MMP-9是AMI病程进展中同样重要的炎性标志物.     

基质金属蛋白酶1、3,基质金属蛋白酶组织抑制剂1和miR-29在大鼠肺纤维化中及活性维生素D3处理后的表达与作用

目的:探讨大鼠肺纤维化发生发展中基质金属蛋白酶1(MMP1)、MMP3、基质金属蛋白酶组织抑制剂1(TIMP1)及miR-29的表达和作用以及活性维生素D3[1,25(OH)_2D_3]处理对这些基因表达的影响。方法:雄性SD大鼠随机分为预防组和治疗组。预防组分为对照组Ⅰ、模型组Ⅰ和给药组Ⅰ,治疗组分为对照组Ⅱ、模型组Ⅱ和给药组Ⅱ。模型组Ⅰ/Ⅱ和给药组Ⅰ/Ⅱ经气管注入博莱霉素,对照组Ⅰ/Ⅱ经气管注入生理盐水。预防组和治疗组分别于术后第2和14天腹腔注射给药,给药组给予活性维生素D3,模型组给予活性维生素D3溶剂,对照组给予生理盐水。预防组的各组分别于术后第14、21、28天处死大鼠取材,治疗组的各组分别于术后第21和28天处死大鼠取材。实时定量PCR检测大鼠肺组织中miR-29a及TIMP1 mRNA表达水平,免疫组织化学检测组织中MMP1、MMP3和TIMP1的表达水平。结果:模型组Ⅰ/Ⅱ和给药组Ⅰ/Ⅱ中的MMP1、MMP3和TIMP1的表达均明显高于相同时间点对照组Ⅰ/Ⅱ中的表达,而miR-29a的表达明显低于相应的对照组Ⅰ/Ⅱ;给药组Ⅰ/Ⅱ中MMP1、MMP3和TIMP1的表达均低于相应时间点的模型组Ⅰ/Ⅱ的表达,而给药组Ⅰ/Ⅱ中miR-29a的表达则高于模型组Ⅰ/Ⅱ中的表达。结论:MMP1、MMP3、TIMP1和miR-29在大鼠肺纤维化发生发展中具有重要作用,活性维生素D3可以促进miR-29表达,抑制MMP1、MMP3、TIMP1的表达;可能是通过miR-29调节包括MMP1、MMP3、TIMP1在内的多种靶基因来发挥抑制纤维化的作用。     

The fibroblast-like synovial cell in rheumatoid arthritis: a key player in inflammation and joint destruction

Although multiple cell types are present in the rheumatoid joint, the fibroblast-like synovial cell (FLS) is among the most prominent. It is now appreciated that the FLS is not only space-filling, but is directly responsible for cartilage destruction, and also drives both inflammation and autoimmunity. In this article, we consider the normal role of the FLS in healthy joints, and review evidence that implicates the FLS as a central player in the propagation of rheumatoid arthritis.     

CD21−/low B cells associate with joint damage in rheumatoid arthritis patients

Depletion of B cells is beneficial in rheumatoid arthritis (RA) patients with autoantibodies to citrullinated proteins (ACPA) and/or the Fc portion of immunoglobulins (rheumatoid factor [RF]), suggesting a role for B cells in disease pathogenesis. To date, however, the identity of specifically pathogenic B cell subsets has not been discovered. One candidate population is identified by the low expression or absence of complement receptor 2 (CD21^?/low B cells). In this study, we sought to determine whether there was any correlation between CD21^?/low B cells and clinical outcome in patients with established RA, either ACPA⁺/RF⁺ (n = 27) or ACPA^?/RF^? (n = 10). Healthy donors (n = 17) were included as controls. The proportion of the CD21^?/low CD27^?IgD^? memory B cell subset in peripheral blood (PB) was significantly increased in ACPA⁺/RF⁺ RA patients compared with healthy donors, and the frequency of this subset correlated with joint destruction (r = 0.57, P < 0.04). The levels of the chemokines CXCL‐9 and CXCL‐10 were higher in synovial fluid than in plasma, and PB CD21^?/low cells expressed the receptor, CXCR3. In synovial fluid, most of the B cells were CD21^?/low, approximately 40% of that population was CD27^?IgD^?, and a third of those expressed the pro‐osteoclastogenic factor receptor activator of the nuclear factor κB ligand (RANKL). This subset also secreted RANKL, in addition to other factors such as IL‐6, even in the absence of stimulation. We interpret these data as reason to propose the hypothesis that the CD27^?IgD^? subset of CD21^?/low B cells may mediate joint destruction in patients with ACPA⁺/RF⁺ RA.     

Dental and temporomandibular joint alterations in rheumatoid arthritis patients and their association with salivary oxidative stress

Background/aim Rheumatoid arthritis (RA) is the most extensive inflammatory arthritis causing permanent deformities in the joint. Increasing evidence suggests that oxidative stress is a substantial factor in the pathogenesis of RA. This study aimed to examine the salivary oxidant-antioxidant status of RA and control groups and to compare these biomarkers by correlating them with disease activity, acute phase reactants, and clinical findings.Materials and methods Age and sex-matched 60 participants including 30 patients with RA and 30 control (50 females, 10 males; mean age: 42.62 ± 10.89 years) were evaluated. RA disease activity and severity were evaluated by the disease activity score 28-C reactive protein (DAS 28-CRP). Rheumatoid factor (RF) positivity, anticitrullinated protein antibodies (ACPA) positivity, erythrocyte sedimentation rate (ESR), CRP, tender and swollen joint counts, and medical treatment regimens of the patients (glucocorticoids, conventional or biologic disease-modifying antirheumatic drugs) were recorded. In the radiographic examination, dental findings, and bone alterations of the temporomandibular joint (TMJ) were recorded and compared for both groups. Saliva samples were obtained for analysis of total antioxidant status (TAS), total oxidant status (TOS), arylesterase (ARE), and oxidative stress index (OSI) levels. The data analysis was conducted by independent sample t-test and chi-square test.Results Condylar erosion was the most common radiographic change in TMJ of RA patients. Osteophyte formation was a prominent finding in the control group. Lower TAS and higher OSI levels were found in RA patients compared with controls (p = 0.013; p = 0.029, respectively). The effect of DAS 28-CRP score on the levels of oxidative stress biomarkers in RA patients was not significant. Conclusion Oxidative stress causes tissue damage in response to excessive mechanical loading, which in turn promotes TMD. However, disease activity has not a prominent impact on the salivary oxidative stress status of RA patients.     

类风湿关节炎的诊断及内科治疗

类风湿关节炎（RA）是一种常见的全身性自身免疫病,目前尚无特异性诊断及治疗方法,尤其是不典型和特殊类型RA易于误诊误治。近年来,AKA、APF、抗RA33、抗CCP、抗Sa及抗BiP抗体等新型自身抗体的发现提高了RA诊断的敏感性和特异性;核磁共振、CT及超声检查等影像学检查提高了RA关节损害的检出率,这些新的血清学检测指标及影像学检查的应用有助于RA的早期诊断。与此同时,新的DMARDs和生物制剂不断问世,RA的治疗手段不断丰富。已经证实,绝大多数RA患者经过早期、联合、个体化的规范治疗,预后良好。     

Soluble TAM receptor tyrosine kinases in rheumatoid arthritis: correlation with disease activity and bone destruction

The TAM receptor tyrosine kinases (TAM RTK) are a subfamily of receptor tyrosine kinases, the role of which in autoimmune diseases such as systemic lupus erythematosus has been well explored, while their functions in rheumatoid arthritis (RA) remain largely unknown. In this study, we investigated the role of soluble TAM receptor tyrosine kinases (sAxl/sMer/sTyro3) in patients with RA. A total of 306 RA patients, 100 osteoarthritis (OA) patients and 120 healthy controls (HCs) were enrolled into this study. The serum concentrations of sAxl/sMer/sTyro3 were measured by enzyme‐linked immunosorbent assay (ELISA), then the associations between sAxl/sMer/sTyro3 levels and clinical features of RA patients were analysed. We also investigated whether sTyro3 could promote osteoclast differentiation in vitro in RA patients. The results showed that compared with healthy controls (HCs), sTyro3 levels in the serum of RA patients were elevated remarkably and sMer levels were decreased significantly, whereas there was no difference between HCs and RA patients on sAxl levels. The sTyro3 levels were correlated weakly but positively with white blood cells (WBC), immunoglobulin (Ig)M, rheumatoid factor (RF), swollen joint counts, tender joint counts, total sharp scores and joint erosion scores. Conversely, there were no significant correlations between sMer levels and the above indices. Moreover, RA patients with high disease activity also showed higher sTyro3 levels. In‐vitro osteoclast differentiation assay showed further that tartrate‐resistant acid phosphatase (TRAP)⁺ osteoclasts were increased significantly in the presence of sTyro3. Collectively, our study indicated that serum sTyro3 levels were elevated in RA patients and correlated positively with disease activity and bone destruction, which may serve as an important participant in RA pathogenesis.     

Dual role of acid-sensing ion channels 3 in rheumatoid arthritis: destruction or protection?

Acid-sensing ion channels (ASIC) are voltage-independent cationic channels that open in response to decrease in extracellular pH. Amongst different subtypes, ASIC3 has received much attention in joint inflammatory conditions including rheumatoid arthritis. There have been a number of studies showing that there is an increase in expression of ASIC3 on nerve afferents supplying joints in response to inflammatory stimulus. Accordingly, a number of selective as well as nonselective ASIC3 inhibitors have shown potential in attenuating pain and inflammation in animal models of rheumatoid arthritis. On the other hand, there have been studies showing that ASIC3 may exert protective effects in joint inflammation. ASIC^?/? animals, without ASIC3 genes, exhibit more joint inflammation and destruction in comparison to ASIC^+/+ animals. The present review discusses the dual nature of ASIC3 in joint inflammation with possible mechanisms.     

IgA rheumatoid factor in mucosal fluids and serum of patients with rheumatoid arthritis: immunological aspects and clinical significance.

In order to gain insight into the production and clinical significance of IgA rheumatoid factor (IgA-RF) in mucosal fluids of patients with rheumatoid arthritis (RA), we examined tear fluid, saliva and serum from 80 patients with RA. Significant correlations were found between IgA-RF levels in tear fluid and saliva (P=0.002, r=0.57), saliva and serum (P<0.001, r= 0.79), and serum and tear fluid (P<0.001, r=0.31). No significant correlations were found between total IgA levels in these fluids. Comparison between circulating and mucosal IgA-RF levels after correction for total IgA, revealed that mucosal IgA-RF levels are on average 2.5 times higher than circulating IgA-RF levels. Analysis of IgA-RF specificity showed that lacrimal and salivary IgA-RF reactivity with various IgG subclasses is similar and differs from serum IgA-RF specificity. These results indicate local production of IgA-RF in salivary and lacrimal glands and support the view of a common origin of IgA-RF producing B cells present in mucosal tissues. Mucosal and circulating levels of IgA and IgA-RF were not associated with tests that quantify tear fluid production. This indicates that mucosal and circulating levels of IgA and IgA-RF in patients with RA cannot be regarded as markers for the development of secondary Sjögren's syndrome.     

基质金属蛋白酶-2和基质金属蛋白酶-9在胶质瘤侵袭和转移中的作用

胶质瘤是一种中枢神经系统恶性肿瘤,病死率高。胶质瘤细胞的侵袭和转移是其致死的重要原因之一,而基质金属蛋白酶通过溶解细胞外基质实现侵袭和转移。基质金属蛋白酶(mat r i x metalloproteinase,MMP)是锌离子依赖性蛋白水解酶,广泛分布于人体各组织和器官,参与细胞外基质的降解和重塑,调节细胞粘着,在肿瘤细胞的侵袭中起着重要作用。本文就基质金属蛋白酶-2和基质金属蛋白酶-9在胶质瘤中的侵袭作用及其机制进行综述。