类风湿关节炎寒湿痹阻证患者血清蛋白组学分析

目的从蛋白质表达水平初步探讨类风湿关节炎中医寒湿痹阻证的本质内涵。方法选择24例2009年7月-2010年9月南京中医药大学附属医院风湿免疫科类风湿关节炎（RA）患者，按中医辨证分型分为寒湿痹阻证组和湿热痹阻证组，每组12例，另选择本院体检中心健康志愿者12名作为正常对照组。采用双向凝胶电泳技术分析各组蛋白图谱，分别比较寒湿痹阻证组和其他两组图谱，找出共同的寒湿痹阻证差异蛋白质点，应用基质辅助激光解吸飞行时间质谱进行鉴定。采用Mascot软件在SwissProt数据库中搜索肽质量指纹谱数据并确定蛋白质。结果寒湿痹阻证组与正常对照组差异蛋白质点共有81个；寒湿痹阻证组与湿热痹阻证组差异蛋白质点共有45个；有13个蛋白点是寒湿痹阻证组较其他两组蛋白表达量均高或均低的蛋白点；通过质谱鉴定和数据库检索获得9个差异蛋白质。这些差异蛋白大多与细胞增殖、细胞分化等细胞事件的抑制相关。结论4．1蛋白、DLC-1蛋白等与细胞增殖和细胞分化相关蛋白具有潜在的作为类风湿关节炎寒湿痹阻证诊断、预后标志物或治疗靶点的意义，也为进一步研究寒湿痹阻证实质提供了依据。

Differential Serum Proteomic Analysis of Rheumatoid Arthritis Patients of Cold dampness Arthralgia Spasm Syndrome

Objective To preliminarily study the essence of rheumatoid arthritis （RA） patients of cold-dampness arthralgia spasm syndrome （CDASS） at the protein expression level. Methods Totally 24 IRA patients were recruited from Department of Rheumatology, Affiliated Hospital of Nanjing University of Chinese Medicine from July 2009 to September 2010.They were assigned to the CDASS group and the dampness-heat arthralgia spasm syndrome （DHASS） group according to Chinese medicine syndrome typ- ing, 12 in each group. The normal control group consisted of 12 healthy volunteers from the Health Exami- nation Center, Affiliated Hospital of Nanjing University of Chinese Medicine. The serum proteins were com- pared between the CDASS group and the normal control group/the DHASS group respectively using two-di- mensional gel electrophoresis. The common differential protein spots of CDASS were analyzed by mass spectrometry. The SwissProt database was inquired using Mascot Software to identify differential proteins. Results There were 81 differential protein spots between the CDASS group and the normal control group. There were 45 differential protein spots between the CDASS group and the DHASS group. Thirteen protein spots were found to be higher or lower in protein expression quantity of the CDASS group when compared with those of the other two groups. Nine differential protein spots were identified by mass spectrometry and database retrieval. It＇s suggested that these proteins were most likely to be related with inhibition of cellular events, such as cell proliferation, cell differentiation, and so on. Conclusion 4.1 protein and DLC-1 pro- tein were of potential significance in the diagnosis, prognostic markers, or treatment targets of RA patients of CDASS, which also provided evidence for further studies on the essence of CDASS.