Study On The Correlation Between Peripheral Blood Tim-3 Expression And TCM Syndrome And Cytokines In Patients With Rheumatoid Arthriti

Purpose:Rheumatoid arthritis(RA)is an autoimmune disease with an uncertain pathogenesis.T cell immunoglobulin mucin-3(Tim-3)is expressed in a variety of cells,participates in the body immune response and plays a negative regulatory role.This study all investigated the differential expression of Tim-3 and cytokines in the peripheral blood of RA patients and healthy controls,To analyze the correlation of Tim-3 and cytokines with the degree of RA disease activity and to investigate the relationship between Tim-3 and cytokines and RA TCM syndrome types.It provides scientific basis for exploring markers of RA activity degree,new therapeutic targets and accurate typing of TCM syndrome.method:1.Seventy-five rheumatoid arthritis patients admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from July 2021 to March 2022 were selected to form the RA group,and 60 healthy controls were selected in the same period to form the HC group.2.Collect the case data,calculate the DAS 28 score of the patients in the RA group,and judge the TCM syndrome type of the RA patients according to the TCM diagnostic and treatment norms.3.Tim-3 expression and serum cytokine levels on peripheral blood T cells were determined by flow cytometry in RA and HC cytometry,Cytokines include:IL-2、IL-4、IL-6、IL-10、IL-17A、TNF-α、IFN-γ。4.The data were collated and analyzed using SPSS25.0 software and plotted with Graph Pad Prism 8.0 software.Results:1.Comparison of test indicators between the RA and HC groups(1)The Tim-3 expression rate on both CD4~+T cells and CD8+T cells was significantly higher in the RA group than in the HC group(p<0.01).(2)The serum levels of IL-2,IL-4,IL-6,IL-10,IL-17A,TNF-α,and IFN-γwere higher in RA group than in HC group,which showed significant differences(p<0.01).2.Results of the correlation analysis among the test indicators in the RA group(1)In RA group,CD4~+Tim-3 was negatively associated with IL-6,IL-17A and TNF-α,all statistically significant(p<0.05),and no correlation with IL-2,IL-4,IL-10 and IFN-γ(p>0.05);In the RA group,peripheral blood CD8~+Tim-3 was negatively associated with IL-6 and IL-17A,with statistically significant differences(p<0.01)and no correlation with IL-2,IL-4,IL-10,TNF-αand IFN-γ(p>0.05).(2)In RA group,CD4~+Tim-3 and CD8~+Tim-3 showed good negative correlation with DAS28(CRP)and DAS 28(ESR),with statistically significant differences(p<0.05).(3)In RA group,DAS 28(CRP)and DAS 28(ESR)were positively associated with IL-6,IL-17A and TNF-α,with statistically significant differences(p<0.05)and no correlation with IL-2,IL-4,IL-10 and IFN-γ(p>0.05).3.Differences between different TCM syndrome(1)From high to low,the 75 RA patients were Cold and dampness obstruction syndrome(GS group)(33.33%)、dampness-heat obstruction syndrome(SR group)(21.33%)、liver and kidney deficiency syndrome(GS group)(17.33%)、qi and Yin deficiency syndrome(QY group)(17.33%)and phlegm-stasis obstruction syndrome(TY group)(10.67%).The proportion of men and age in each syndrome group were matched,with no statistical difference(p>0.05).(2)Comparison of the cytokines among the syndromes,Serum IL-2 level,dampness-heat obstruction syndrome is higher than phlegm-stasis obstruction syndrome;Serum IL-4 level,liver and kidney deficiency syndrome is higher than dampness-heat obstruction syndrome;Serum IL-6 level,cold and dampness syndrome was significantly higher than liver and kidney deficiency and phlegm stasis syndrome;Serum IL-17A level,cold and dampness obstruction syndrome is significantly higher than dampness-heat obstruction syndrome,qi and Yin deficiency syndrome and phlegm stasis obstruction syndrome;The serum TNF-αlevel,cold and dampness obstruction syndrome is higher than dampness-heat obstruction syndrome;serum IFN-γlevel,dampness-heat obstruction syndrome,qi and Yin deficiency syndrome and phlegm stasis obstruction syndrome are higher than liver and kidney deficiency syndrome and cold and dampness obstruction syndrome;Serum IL-10 levels were not significantly different among the syndrome types.The difference between the two groups was statistically significant(p<0.01),but the other groups(p>0.05).(3)The expression rate of Tim-3 on CD4~+T cells,phlegm-stasis obstruction syndrome was higher than Cold and dampness obstruction syndrome;the expression rate of Tim-3 on CD8~+T cells,liver and kidney deficiency was higher than dampness-heat syndrome,with statistically significant difference(p<0.01).(4)DAS 28 score levels,the dampness-heat syndrome and cold and dampness syndrome were higher than the qi and Yin deficiency syndrome,with a statistically significant difference(p<0.01).Conclusion:1.The expression of Tim-3 was increased on peripheral CD4~+T cells and CD8~+T cells in RA patients,and the expression rate of Tim-3 was inversely correlated with the serum levels of pro-inflammatory factors and with the degree of disease activity in RA.Tim-3 may be a potential new marker for assessing RA severity and may be a new target for RA therapy.2.The serum levels of IL-2,IL-4,IL-6,IL-10,IL-17A,TNF-αand IFN-γwere increased in the serum of patients with RA.3.The levels of IL-6,IL-17A,and TNF-αproinflammatory factors were positively correlated with the degree of RA disease activity.4.There were distribution differences in TCM syndrome patterns in RA patients,with higher serum levels of proinflammatory factors IL-2,IL-6,IL-17A,TNF-α,and IFN-γin cold-dampness syndrome and dampness-heat syndrome and low expression of IL-4 and Tim-3,and high degree of disease activity.The serum level of pro-inflammatory factors was low in phlegm-stasis syndrome、qi and Yin deficiency syndrome and liver and kidney deficiency syndrome,and low degree of disease activity.