人内质网分子伴侣BiP抗原表位筛选及其在RA血清学诊断中的作用研究

目的:筛选鉴定人内质网分子伴侣BiP抗原表位多肽,探讨其在类风湿性关节炎(Rheumatoid arthritis,RA)血清学诊断中的价值.方法:运用计算机软件分析BiP蛋白的结构特点及抗原决定簇分布,根据结果设计合成系列多肽.比较合成多肽与RA患者血清(BiP抗体阳性)IgG的反应强弱,鉴定抗原抗体反应最强的抗原表位多肽.进一步以获得的BiP抗原表位多肽作为包被抗原,检测79例RA患者、34例系统性红斑狼疮(SLE)患者、66例干燥综合征(SS)患者和173例正常人血清中抗BiP抗原表位多肽IgG抗体水平.结果:筛选到一条与RA患者血清反应最强的多肽(N403),抗N403多肽IgG抗体在RA患者中的阳性率(67%),明显高于SS患者(29%)、SLE患者(0%)、和正常人(0%)(P＜0.01).抗N403多肽IgG抗体在RA血清学诊断中的敏感性为67%,特异性为93%.而且该抗体的检测对于RF、CCP、HRF、RA33、AKA、APF等抗体阴性的RA患者的诊断具有重要意义.结论:筛选获得的BiP抗原表位多肽N403,其检测抗体在RA临床血清诊断中具有很好的应用价值.     

内质网分子伴侣GRP78在大鼠脊髓缺血再灌注损伤中的表达变化

目的观察在大鼠脊髓缺血再灌注损伤(SCII)过程中内质网分子伴侣GRP78的表达变化,并探讨其意义。方法健康成年Wistar大鼠55只,随机分为两组:(1)脊髓压迫缺血再灌注组50只,每个时间点10只,采用自制压迫装置制备脊髓压迫缺血再灌注模型;(2)假手术对照组5只,只做全椎板切除不做脊髓压迫。用免疫组化、West-ernblot和TUNEL等方法,分别于缺血再灌注后30min、3、7、11和23h,检测压迫段脊髓组织中GRP78的表达变化及细胞凋亡情况。结果再灌注30min后,GRP78在压迫段脊髓开始表达上调,7h达峰值,11h表达回落,23h显著减少。TUNEL染色显示,神经细胞的凋亡指数随着再灌注时间的延长而升高。结论GRP78在脊髓缺血再灌注损伤中呈现时序性的表达变化,这可能是脊髓内源性保护机制之一。     

抗CCP抗体和抗MCV抗体在RA中的表达及意义

为探讨抗环瓜氨酸肽(cyclic citrullinated peptide, CCP)抗体和抗突变型瓜氨酸波形蛋白(mutated citrullinated vimentin, MCV)抗体在RA中的表达及临床意义,选择185例RA初诊患者作为RA组,70例其他风湿性疾病患者作为疾病对照组,80例健康者作为健康对照组,采用ELISA检测入选对象的血清抗CCP抗体、抗MCV抗体和RF水平,并监测其治疗前后的浓度变化情况。结果显示,抗CCP抗体和抗MCV抗体在RA组患者中的表达水平显著高于疾病对照组和健康对照组(P0.05);抗CCP抗体和抗MCV抗体诊断RA的灵敏度分别为83.8%和91.4%,诊断RF阴性RA的灵敏度分别为65.2%和81.0%。抗CCP抗体和抗MCV抗体在关节肿胀数 3、Sharp评分 50、DAS28高评分RA患者中的水平明显升高(P0.05),抗MCV抗体水平在CRP 50 mg/L、有关节腔积液的RA患者中明显升高(P0.05)。在RA缓解组中,抗MCV抗体水平在治疗3个月后明显下降(P0.05),抗CCP抗体在治疗6个月后明显下降(P0.05);在RA未缓解组中,抗CCP抗体和抗MCV抗体水平在治疗前后差异均无统计学意义(P 0.05)。提示抗CCP抗体和抗MCV抗体不仅在RA诊断和治疗中有较高的临床意义,两者联合检测还有利于对RA患者骨破坏情况、炎症反应等临床特征进行判断。     

抗CCP抗体和RF联检在RA诊疗中的临床价值

目的：研究抗环瓜氨酸肽（anti-cyclic citrullinated peptide,Anti-CCP）（抗CCP抗体）和RF的检测在类风湿关节炎（RA）诊疗中的临床价值。方法：分别用酶联免疫吸附试验（ELISA）、BeckMan全自动蛋白分析仪同时检测早期RA组（病程〈1年）42例,RA组（病程〉1年）40例,非RA对照组40例患者血清抗CCP抗体和RF。结果：早期RA组、RA组的抗CCP抗体、RF阳性率显著高于非RA对照组（P〈0.05）RA组抗CCP水平显著高于早期RA组（P〈0.01）,两者RF无显著差别（P〉0.05）。RA组与早期RA组CCP抗体与RF二者无相关性。结论：联检抗CCP抗体、RF有助于类风湿的早期诊断和预测病情的进展。     

人细胞核诱导凋亡因子1在大肠杆菌中的表达、纯化及多克隆抗体制备

目的:构建人核凋亡诱导因子1(NAIF1)原核表达质粒,在大肠杆菌中表达及纯化NAIF1融合蛋白,制备兔抗NAIF1多克隆抗体,并对其特性进行初步鉴定。方法:PCR法获得人NAIF1序列并将其克隆到原核表达载体pET-32a中,重组表达质粒在大肠杆菌BL21(DE3)中诱导表达蛋白,经变性、Ni+柱亲和纯化、复性后得到纯化的重组人NAIF1蛋白,免疫大耳白兔,制备兔抗人NAIF1多抗血清,以ELISA和Westernblot方法检测其效价和特异性。结果:成功获得了高纯度的人NAIF1重组蛋白和高效价的兔抗人NAIF1多抗血清,ELISA检测多抗效价达到1∶500000,Westernblot检测证明多抗特异性良好。结论:获得了高纯度的人NAIF1重组蛋白和兔抗人NAIF1多抗血清,为后续针对NAIF1基因功能的研究提供了重要实验材料。     

类风湿性关节炎患者血清中Ⅱ型胶原抗体的检测及临床意义

<正> 自身免疫是类风湿性关节炎(RA)发病中的重要因素,患者血清中存有抗自身IgG的抗体——类风湿因子。1977年,David和Threntham首次发现了50％的患者血清中存有抗Ⅱ型胶原的抗体,此种抗体与类风湿的发病和反复出现的症状有明显联系,我们应用ELISA检测,并对实验条件做了优选,取得满意结果。     

RA33/36抗原的提取、半纯化及 相应抗体的检测

目的　提取、半纯化RA33/ 36抗原 ,探讨RA33/ 36抗体对类风湿关节炎 (RA)诊断的特异性及敏感性。方法　以Ehrlich腹水癌细胞核提取物作粗抗原 ,采用肝素 琼脂糖凝胶CL - 6B层析柱对此粗抗原进行分离半纯化。分别用粗抗原和半纯化抗原作抗原 ,免疫印迹法检测 12 0例RA患者、40例红斑狼疮 (SLE)患者、35例干燥综合征 (SS)患者、2 5例系统性硬化症 (SSc)患者、10例混合性结缔组织病 (MCTD)患者和 30例正常对照血清中的RA33/ 36抗体。结果　①SDS -PAGE示 2种抗原在相对分子质量 (Mr)为 33× 10 3 和 36× 10 3 处均可见条带 ,半纯化抗原杂带较粗抗原明显减少。②与粗抗原相比 ,半纯化抗原免疫印迹反应条带明显减少 ,且特别清晰 ,但阴性和阳性结果相同。③RA36抗体并不总是与RA33抗体以 2条带的形式同时出现。④RA33抗体和RA36抗体对RA诊断的敏感性差异无显著性 ,而特异性RA36抗体优于RA33抗体。⑤RA36抗体与RF、APF、ESR、关节相X线分期、关节功能分级无明显相关性。结论　半纯化抗原可直接用于检测RA33/ 36抗体 ,或用其作质量控制 ;RA36抗体可能是RA的一种可作为标记的特异性抗体 ,应对此抗体进行更深入研究。     

应用伴侣分子在大肠杆菌表达系统高效表达家蝇天蚕素

目的应用伴侣分子在大肠杆菌表达系统中高效表达家蝇天蚕素,研究伴侣分子对家蝇天蚕素基因在大肠杆菌中表达的影响。方法RT—PCR克隆家蝇的天蚕素成熟肽（mature cecropin,MC）与泛素（ubiquitin,UBI）基因,利用生物信息学方法分析硫氧还蛋白（thioredoxin,Trx）-MC和MC分子结构及Trx-MC分子和Trx-UBI—MC两种融合蛋白mRNA 5’端的二级结构的异同。分别构建pET32a-MC和pET32a—UBI—MC两种重组质粒,转化人大肠杆菌（E.coli）BL21（DE3）中。检测Trx-MC融合蛋白的表达和pET32a—MC和pET32a-UBI—MC在相同诱导时间及诱导剂浓度的条件下,融合蛋白表达量的差异。结果生物信息学分析结果显示MC分子被Trx分子包裹在其内部,MC分子的细胞毒性被去除,使其可以在大肠杆菌中正常表达。分子生物学实验结果进一步验证了生物信息学分析结果的正确性。同时,也显示UBI分子的加入,未影响融合蛋白质Trx-UBI-MC与Trx—MC的mRNA5’端二级结构。并且Trx-UBI-MC融合蛋白在全菌蛋白中的含量明显高于Trx—MC。结论Trx作为伴侣分子包裹了MC的天然结构,使其对宿主菌无毒性。UBI作为伴侣分子,在相同转录水平、翻译水平条件下,明显提高了蛋白的表达量。     

人DcR3融合蛋白的表达、纯化及多克隆抗体的制备

目的:制备DcR3融合蛋白及其多克隆抗体,并鉴定其特异性。方法:将亚克隆构建的pET28a( )/DcR3重组表达质粒转化入大肠杆菌(E.coli)BL21菌株,IPTG诱导表达,镍柱亲和层析法纯化目的蛋白,SDS-PAGE及Western blot分析蛋白产物,将纯化的目的蛋白免疫家兔制备多克隆抗体,并对其进行纯化及鉴定。结果:pET28a( )/DcR3重组表达质粒在E.coli中诱导表达相对分子质量(Mr)为33000的目的蛋白,表达量约占菌体蛋白总量的38%,纯化后的目的蛋白纯度达98%。Western blot显示纯化蛋白与抗DcR3单克隆抗体(mAb)具有良好的反应性。纯化后多克隆抗体效价达1.28×10-6。结论:DcR3蛋白在E.coli中得到高效表达,成功制备高纯度DcR3蛋白及高效价抗DcR3多克隆抗体,为研究DcR3在组织中的表达、分布,研制ELISA试剂盒以检测恶性肿瘤及自身免疫性疾病等患者血清DcR3表达水平提供实验基础。     

抗人CD3单链抗体的表达及其分离纯化

本研究将构建的抗人ＣＤ３单链抗体基因，克隆到融合蛋白表达载体ｐＧＥＸ－４Ｔ－１中，用ＩＰＴＧ诱导表达ＧＳＴ－ＳｃＦｖ融合蛋白，并以ＳＤＳ－ＰＡＧＥ分析，在Ｍｒ为５２０００左右出现一条新生蛋白带，表达量约占菌体总蛋白的４０％。经初步纯化和复性后，用ＧＳＴ亲和色谱纯化，再经凝血酶水解获得抗人ＣＤ３ＳｃＦｖ，竞争结合抑制实验证明，该表达产物具有ＣＤ３亲和活性     

Correlative studies of rheumatoid factors and anti-viral antibodies in patients with rheumatoid arthritis.

An analysis of the relationship between the immune response to ubiquitous herpes family viruses, namely Epstein-Barr virus (EBV), cytomegalovirus (CMV), and varicella-zoster virus (VZV) and the presence of rheumatoid factors (RF), which are autoantibodies characteristic of patients with rheumatoid arthritis (RA), was conducted. Antibody profiles (RF, anti-viral antibodies) were monitored in the serum of the RA patients, and in normal individuals. No patient was found to have circulating RF in the absence of anti-viral antibodies. When the patients and normal controls were subdivided according to the presence of serum RF, it was found that when RF were present, the frequency of anti-CMV antibodies, but not anti-EBV or anti-VZV antibodies, was significantly higher (P = 0.02) when compared with RF-negative individuals. The titres of anti-CMV but not anti-VZV antibodies were found to increase in the RA patients with disease duration. To see if these viruses could stimulate RF production in vitro, peripheral blood mononuclear cells (PBMC) isolated from the patients and normal controls were stimulated with viral antigens. PBMC from normal controls, but not from RA patients, appeared to be responsive to viral antigen stimulation and produced RF. These data suggest that the immune response to CMV, to a greater extent than to EBV or VZV, correlates with the presence of RF.     

The production of human monoclonal autoantibodies from patients with rheumatoid arthritis by the EBV-hybridoma technique

Rheumatoid lymphocytes tend to transform 'spontaneously' in vitro because of prior infection with Epstein Barr virus (EBV). They are particularly difficult to use in experiments involving cell hybridisation, because in the conventional half-HAT system unfused transformed cells may be confused with hybrids. We describe how the HAT-sensitive, ouabain-resistant human B lymphoblastoid cell line KR4, originally developed to 'rescue' EBV induced B cell clones, can be fused successfully with peripheral blood lymphocytes from patients with rheumatoid arthritis to produce unequivocal hybrids.     

早期和非早期类风湿关节炎患者外周血CD4+ T细胞基因表达差异

为了探讨早期、非早期类风湿关节炎(RA)患者与健康人外周血CD4+T细胞的基因表达差异。采集早期、非早期RA患者及健康人空腹静脉血,纯化得到CD4+T淋巴细胞,利用基因芯片检测和分析技术,探索早期、非早期RA患者与健康人外周血CD4+T淋巴细胞基因表达差异。结果:非早期与早期RA患者比较,外周血CD4+T淋巴细胞有83条基因表达存在显著性差异,其中上调3条,下调80条,主要涉及信号转导。与健康人比较,有45条基因异常表达,其中13条基因在RA的早期和非早期较正常对照组表达降低,30条在早期高表达;只有2条与早期与非早期比较差异表达的83条基因重复;差异基因涉及信号转导和免疫应答,以及相关的信号转导途径。早期与非早期RA患者外周血CD4+T淋巴细胞基因表达谱存在明显差异,与健康人比较的差异基因与RA早期和非早期比较的差异基因不一致。     

Anti-thyroid antibodies and thyroid dysfunction in rheumatoid arthritis: Prevalence and clinical value

Objectives: The aim of this study was to assess thyroid function as well as the prevalence and clinical value of anti-thyroid antibodies in patients with rheumatoid arthritis (RA).

Methods: Seventy patients with active RA (ACR criteria), 9 males and 61 females, mean age 47 years (range 15–77) were analyzed. Anti-thyroperoxidase (TPOAb) and anti-thyroglobulin antibodies (TgAb) were tested using radioimmunoassay. Free thyroxine (FT4) and free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) serum levels were measured using electro-immunochemiluminescence (ECLIA, Elecsys Roche). Clinical variables, including tender and swollen joint count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP) and antinuclear antibodies (ANA) were also evaluated. Statistics were performed by the SPSS statistical software for Windows.

Results: Twenty-six patients (37%) with RA were positive for TPOAb and 16 (23%) for TgAb. In 5 (7.1%) patients TSH level was slightly elevated, ranging between 4.52 and 15.65 UI/ml. The increase of TSH levels was associated with normal FT4 in 3 cases (4.2%) and with reduced FT4 in 2 cases (2.8%). One patient (1.5%) had low TSH serum value along with normal FT4. No differences in clinical and serological data between anti-thyroid positive and negative patients were observed.

Conclusion: Our study shows an increased prevalence of anti-thyroid antibodies in RA patients with a low prevalence of hormonal alterations. However, anti-thyroid antibodies do not seem to identify any peculiar RA phenotype.     

Subclass distribution of IgG antibodies to the rat oesophagus stratum corneum (so-called anti-keratin antibodies) in rheumatoid arthritis.

Serum IgG, labelling the stratum corneum of the rat oesophagus epithelium, so-called anti-keratin antibodies (AKA) constitute the most specific marker for the diagnosis of rheumatoid arthritis. In this study, we investigated 31 IgG AKA-positive rheumatoid sera and 21 control sera from patients with non-rheumatoid inflammatory rheumatic diseases. The serum level of IgG1,2,3 and 4 was determined by radial immunodiffusion and the subclass distribution of IgG AKA by a three-step semi-quantitative immunofluorescence assay using standard monoclonal antibodies specific for each of the four human IgG subclasses. In the rheumatoid sera, the serum level of IgG1 was found to be significantly increased and the level of IgG2 significantly decreased with regard to the control sera, while the levels of IgG3 and 4 as well as total IgG were in the normal range. IgG1,2,3, and 4 AKA were detected in 27 (87%), 6 (19%), 4 (13%) and 11 (35%) of the 31 rheumatoid sera, respectively, and were found to be independent of the clinical and biological indices of the disease. In spite of inter-individual heterogeneity, two predominant profiles were distinguished: IgG1 (alone) and IgG(1 + 4), which together represented 18 sera (58%). The large predominance of IgG1 AKA and the quasi-absence of IgG2 AKA suggest that the recognized antigen may be partly comprised of protein. Moreover, the high frequency of occurrence of IgG4 AKA might result from chronic exposure to the eliciting antigen, which could be a genuine autoantigen since we demonstrated that it is also present in the stratum corneum of human epidermis.     

Positive association between serum thymic stromal lymphopoietin and anti-citrullinated peptide antibodies in patients with rheumatoid arthritis

Thymic stromal lymphopoietin (TSLP) has been suggested recently to play an important role in the pathophysiology of rheumatoid arthritis (RA). However, there is little information on serum TSLP concentrations in RA and its clinical significance. The present study investigated whether serum TSLP concentrations were affected in patients with RA. Using an enzyme-linked immunosorbent assay (ELISA), we measured TSLP concentrations in the serum obtained from 100 patients with RA, 60 patients with osteoarthritis (OA) and 34 healthy volunteers. We also investigated the correlation between serum TSLP concentrations and clinical parameters of disease activity in RA [disease activity score using 28 joint counts (DAS28)-C-reactive protein (CRP), DAS28-erythrocyte sedimentation rate (ESR), Clinical Disease Activity Index (CDAI]), patient’s/-physician’s Visual Analogue Scale (VAS), swollen joints count, tender joints count, CRP, ESR and matrix metalloproteinase-3 (MMP-3) concentrations]. In addition, we investigated the correlation between serum TSLP concentrations and anti-citrullinated peptide antibody (ACPA) and serum tumour necrosis factor (TNF)-α. Serum TSLP levels in patients with RA were significantly higher than those in patients with OA and in healthy volunteers. Interestingly, serum TSLP concentrations were correlated significantly with ACPA titres, but not with other clinical parameters. There was a significant increase in serum TSLP concentrations in patients with RA, which was correlated positively with serum ACPA titres. These findings suggest that in patients with RA, TSLP may play a role in ACPA production by B cells.     

地高辛标记人IL-2cDNA探针的制备及临床初步应用

目的：制备ＩＬ－２地高辛标记探针,探讨类风湿关节炎（ｒｈｅｕｍａｔｏｉｄａｒｔｈｒｉｔｉｓ,ＲＡ）患者外周血淋巴细胞ＩＬ－２ｍＲＮＡ的表达情况。方法 采用斑点杂交技术,对６例正常对照和１２例ＲＡ患者进行研究,结果：（１）从ｐＵＣ１２质粒子扩增制备了长度为１ｋｂ和ＩＬ－２ｃＤＮＡ片段,用地高辛标记后制备探针,其敏感性达１ｐｇ同源ＤＮＡ,且特异性较高,（２）１２例ＲＡ患者外周血淋巴细胞ＩＬ－２ｍＲＮＡ     

Lung inflammation in the pathogenesis of rheumatoid arthritis

The primary manifestation of rheumatoid arthritis (RA) is articular disease; however, extra-articular disease can also occur. In particular, pulmonary disease is a leading cause of morbidity and mortality in individuals with RA. Herein, we will review the types, prevalence, risk factors, and potential pathophysiology of lung disease in individuals with established RA. We will also discuss the emerging understanding of potential role of the lung in the generation of RA-related autoantibodies during a period of disease development termed “pre-RA.” Finally, we will discuss a research agenda outlining the next steps to improve our understanding and management of lung inflammation and lung disease throughout the natural history of RA.     

UBASH3A gene polymorphisms and expression profile in rheumatoid arthritis

Objectives: Recent evidence has demonstrated that UBASH3A play a pivotal role in multiple autoimmune diseases. In this study, we explored the association between UBASH3A gene single-nucleotide polymorphisms (SNPs) and rheumatoid arthritis (RA) in a Chinese Han population. We also comparatively evaluated the UBASH3A expression profile in peripheral blood mononuclear cells (PBMCs) from patients with RA and healthy controls.

Methods: Four UBASH3A polymorphisms (rs1893592, rs11203203, rs2277798, and rs3788013) were studied in 553 patients with RA and 587 controls in a Chinese population. Genotyping was performed using the Fluidigm 192.24 Dynamic Array Integrated Fluidic Circuit (IFC). For gene expression study, UBASH3A mRNA levels of 30 RA patients and 31 healthy individuals were assessed by real-time quantitative polymerase chain reaction (RT-qPCR). Data were analyzed by SPSS 19.0 software.

Results: A significant association between rs1893592 polymorphism and RA was found under all genetic models (all p<.05). We also discovered a significant association between rs3788013 polymorphism and RA in the allele and genotype distributions, as well as the recessive model (all p<.05). Moreover, we found the genotype distribution and allele frequency of rs1893592 were significantly associated with RF phenotype in the RA patients (χ²?=?6.786, p=.034; χ²?=?4.534, p=.033; respectively). We also found the genotype distribution and allele frequency of rs2277798 were significantly associated with anti-CCP phenotype in the RA patients (χ²?=?7.873, p=.020; χ²?=?4.473, p=.034; respectively). However, we did not detect any significant associations between rs11203203 and RA susceptibility and autoantibody profiles (all p>.05). The mRNA expression of UBASH3A was increased in PBMCs of patients with RA when compared to healthy controls (p=.001).

Conclusions: Our observations suggested that the dysregulation of UBASH3A might be associated with the pathogenesis of RA, and UBASH3A gene polymorphisms (rs1893592 and rs3788013) might contribute to RA susceptibility in Chinese Han population.