| Background:Ankylosing spondylitis (Ankylosing Spondylitis, AS) is a chronic progressive joint disease of the spine, and serious threat to human health. With the development of medical science, diagnostic techniques and treatment for AS have a considerable progress. But its pathogenesis is still unclear, and synovial hyperplasia, lymphoid infiltration and pannus formation are still one of the most important reasons for relapse and disability. Angiogenesis is found as an important pathophysiological process in AS occurrence and development. Stromal cell derived factor-1 (SDF-1) and its specific receptor CXCR4 form CXCR4/SDF-1 axis coordination with vascular endothelial growth factor (VEGF) promotes AS angiogenesis by increasing the chemotaxis of inflammatory cells. It is significant to detect above mechanism for AS treatment, delaying joint deformity, improving quality of life, and prognosis judgement, and so on.Objective:To explore the effect of CXCR4/SDF-1 axis and the VEGF serum level on AS pathogenesis and provide new ideas for AS treatment and prognosis by examine the level of CXCR4 in peripheral blood mononuclear cells (PBMCs) and serum VEGF and SDF-1 expression and analyze the relationship among above three indexes.Methods:30 AS patients and 20 healthy persons were selected as subjects, which were matched on age and sex. PBMCs and serum from subjects were collected. Clinical examinations such as C- response protein (CRP), erythrocyte sedimentation rate (ESR), blood routine examination, urine routine examination, liver function and kidney function were examined. Flow cytometry (FCM) was used to detected the expression of CXCR4 on PBMCs. Enzyme linked immunosorbent assay (ELISA) was used to determine VEGF and the SDF-1 serum level. Relationship among in CXCR4, SDF-1 and VEGF, and the relationship between above three indexes and disease activity indexes(ESR,CRP) were analyzed.Results:1 The expression of CXCR4 on PBMCs of AS patients group was (20.657±6.321)%. The expression of CXCR4 on PBMCs of healthy persons group was (0.393±0.126)%. There was significant difference between AS patients and healthy persons in CXCR4 expression (P<0.05).2 VEGF and SDF-1 serum levels were (801.33±268.51) pg/ml and (2 651.17±714.78) pg/ml respectively in AS patients group. VEGF and SDF-1 serum levels were (76.25±20.89) pg/ml and (836.25±214.47) pg/ml respectively in healthy persons group. There were significant differences between AS patients and healthy persons in VEGF and SDF-1 serum levels (all P<0.05).3 There were obvious correlations among the VEGF, CXCR4 and SDF-1 (coefficient of correlation=0.828,0.638,0.723 respectively, all P<0.05).4 There was positive correlation between the VEGF serum level and the levels of ESR and CRP (coefficient of correlation=0.584,0.723 respectively, all P<0.05). There was no obvious correlation between the CXCR4, SDF-1 serum level and the levels of ESR and CRP (coefficient of correlation=0.186,0.500,0.232,0.477, respectively, all P>0.05).Conclusions:1 CXCR4/SDF-1 response axis play an important role in the development and sustenance of AS inflammation pathological change. Expression level of CXCR4 and SDF-1 in the AS patients is significantly higher,then increase the strong chemotaxis to lymphocytes and monocytes and strengthen inflammation reaction in AS.2 Increased VEGF in serum accelerates neovascularity formation in joint of AS patients and promotes the occurrence and development of AS patients'joint synovitis.3 CXCR4/SDF-1 response axis and VEGF play synergistic effect in the occurrence and development of AS.4 VEGF with ESR and CRP can be as reliable indexes of auxiliary diagnosis, monitoring patients'condition and therapic effect of AS, while CXCR4,SDF-1 reaction axis can not. |
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