类风湿关节炎患者HLA-DR_4与Th_1/Th_2细胞因子的平衡关系

目的了解类风湿关节炎(RA)患者HLA-DR4与Th1/Th2细胞因子平衡之间的关系,探讨HLA-DR4在RA患者免疫应答中的作用。方法分别用聚合酶链反应-序列特性引物基因扩增法(PCR-SSP)对98例RA患者进行HLA-DR4基因型鉴定,用酶联免疫吸附实验(ELISA方法)测定IL-4、INF-γ。以INF-γ/IL-4反映Th1/Th2免疫应答的强度。结果INF-γ、IL-4、INF-γ/IL-42组间比较有显著性差异(P<0.01)。RA组中HLA-DR4阳性与阴性组INF-γ、IL-4、INF-γ/IL-4、ESR、CRP比较均有显著性差异(P<0.01)。结论RA患者存在Th细胞分泌细胞因子失衡,失衡模式为Th1型细胞因子占优势,而Th2型细胞因子相对低下,其HLA-DR4阳性与阴性组比值失衡程度有显著性差异,且与病情活动性及严重程度相关。

Relationship between HLA-DR4 and TH1/TH2 cytokine balance in patients with rheumatoid arthritis

Objective It is to comprehend the relationship between HLA-DR_4 and TH_1/TH_2 cytokine balance in patients with rheumatoid arthritis (RA), and to discuss the action of HLA-DR_4 in immunological response of patients with RA. Methods The method of DNA amplification with sequence-specific primers (PCR-SSP) was used to determine HLA-DR_4 allele. The serum levels of INF-γ and IL-4 were measured with enzyme linked immunosorbent assay. The strength of immunological response of TH_1/TH_2 was reflected by INF-γ/IL-4. Results There were significant differences on INF-γ, IL-4 and INF-γ/IL-4 between the two groups (P<0.01). There were significant differences on INF-γ, IL-4, INF-γ/IL-4, ESR and CRP between HLA-DR_4 positive group and HLA-DR_4 negative group in RA group (P<0.01). Conclusion There is an imbalance of Th cytokine production in the patients with RA, which exhibited TH_1 cytokine dominant and TH_2 cytokine lower. There is significant difference on the ratio imbalance degree between HLA-DR_4 positive group and HLA-DR_4 negative group in RA patients, and it is related to disease activity and serious degree.