| Objective:To study the changes and significance of serum tissue inhibitor matrix metalloproteinase-1(TIMP-1)levels in patients with active axial spondyloarthritis(ax SpA)after treatment with recombinant human tumor necrosis factor-αreceptor II-IgG Fc antibody fusion protein(rhTNFR-Fc).Methods: A total of 24 active ax SpA patients who were admitted to the department of rheumatology and immunology of the first affiliated hospital of guangxi medical university from February 2015 to December 2016 were collected according to the inclusion criteria.All patients were followed up for 24 weeks.In the first 12 weeks(stage 1),all patients were treated with rhTNFR-Fc(50mg once a week)and traditional drugs(thalidomide 75 mg once a night and salazosulfopyridine 1.0g twice a day).At the second 12 weeks(stage 2),the patients were randomly divided into two groups: group A(n=12),continued to follow the first stage regimen,and group B(n=12)stopped to use rhTNFR-Fc,and continued to follow the traditional drug therapy.The Serum TIMP-1 levels were determined by enzyme-linked immunosorbent assay(ELISA)in 24 casesof ax SpA patients at baseline(week 0),6 weeks,12 weeks,18 weeks and 24 weeks.Used SPSS statistical software to analyze the changes of serum timp-1level and its correlation with ESR,CRP,BASDAI,BASFI and ASDAS-CRP scores.Results: 1.The baseline level of serum TIMP-1 in ax SpA patients was301.38±99.54(ng/ml),and that in the healthy control group was 644.22±93.60(ng/ml).The baseline level of serum TIMP-1 in ax SpA patients was lower than that in the healthy control group,and the difference was statistically significant(P < 0.05).2.At week 6,12,18(A),18(B),24(A)and 24(B),the serum TIMP-1 levels of ax SpA patients were: 541.50 ± 172.93(ng/ml),624.27 ±144.19(ng/ml),733.38± 123.00(ng/ml),534.94± 224.48(ng/ml),668.11±104.36(ng/ml),561.88 ± 176.52(ng/ml).3.Compared with the previous follow-up point,the serum TIMP-1 level of ax SpA patients increased at week 6and 12 after treatment,and the difference was statistically significant(P < 0.05).The serum TIMP-1 level of group A patients increased at week 18 and 24 after treatment,and the difference was statistically significant(P < 0.05).There was no significant difference in TIMP-1 level between the follow-up points(P>0.05).4.Comparison of serum TIMP-1 level between group A and group B: at week 18,serum TIMP-1 level in group A was higher than that in group B,and the difference was statistically significant(P < 0.05).At week 24,the serum TIMP-1level of group A was higher than that of group B,but the difference between the two groups was not statistically significant(P > 0.05).5.The baseline level of serum TIMP-1 in ax SpA patients in the active stage(week 0)was not correlated with ESR,CRP,BASDAI,BASFI and ASDAS-CRP scores(P > 0.05).The serum TIMP-1 levels at week 6,12,18(A)and 24(A)were not correlated with ESR,CRP,BASDAI,BASFI and ASDAS-CRP scores(P > 0.05).SerumTIMP-1 and ESR,CRP and ASDAS scores were positively correlated at week18(B),with statistically significant difference(P < 0.05),but not correlated with BASDAI and BASFI scores(P > 0.05).Serum TIMP-1 level was positively correlated with ESR and CRP in patients at week 24(B),and the difference was statistically significant(P < 0.05),but not correlated with BASDAI,BASFI and ASDAS-CRP scores(P > 0.05).Conclusions: 1.Serum TIMP-1 level of ax SpA patients in active phase was lower than that of healthy controls.2.After treatment with rhTNFR-Fc,serum levels of TIMP-1 increased in ax SpA patients in the active phase.It was speculated that rhTNFR-Fc could protect joints and inhibit osteoarthritis by blocking tumor necrosis factor,up-regulating TIMP-1,inhibiting MMPs and other mechanisms. |
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