Clinical Analysis Of Chronic Periaortitis And Preliminarily Exploration Of The Underlying Inflammatory Mechanism

Objective This study was undertaken to investigate the clinical characteristics of CP and preliminarily explore the role of CDCA-FXR/IL-6 pathway in the underlying inflammatory mechanism of CP,providing novel insights into the diagnosis and treatment of the disease.Methods Clinical characters of 17 CP patients were analyzed retrospectively and serum CDCA levels of 5 CP patients were detected by ultra performance liquid chromatography-tandem mass spectrometry method,as with the patients from each control group;the pathological specimen obtained by retroperitoneal puncture was stained by immunohistochemistry to detect the expression of IL-6,F4/80 and FXR.RT-PCR,ELISA or western were used to detect the regression of cytokines by FXR agonist and dual-luciferase report genes were constructed to explore the combination of FXR and IL-6 promoter.In addition,flow cytometry was used to explore the effection of FXR agonist on the polarization of macrophage.Results Of the 17 CP patients,male: female = 3.25:1 and the average age of onset was 62.5±8.36 years.Serum CDCA levels were significantly reduced in CP patients compared with each control group.Immunohistochemical results showed that expression of IL-6 was increased in the pathological specimen and F4/80 and FXR were also expressed.Activation of FXR resulted in the decreased expression of cytokines such as TNF-α、IL-1β and IL-6 in macrophage.Data of dual-luciferase report gene system showed that FXR may inhibit the expression of IL-6 by binding to ER10 site of IL-6 promoter,and there is no effection of FXR agonist on the polarization of macrophage.Conclusion CP is a rare inflammatory disease with a insidious onset and various clinical symptoms.Reduced CDCA in serum may be a new character of this disease and CDCA-FXR/IL-6 pathway may play a role in the pathogenesis of CP.