| Juvenile rheumatoid arthritis (JRA) is a kind of disease characteristic ofchronic arthritis which children under 16 years old often suffered from. Generalpathological change JRA is chronic inflammation of synovium of joint andconjunction organization. If the arthritis lasts too time, arthrodial cartilage or thetissues under gristle will be damaged, even led to permanence artic crippledom atthe end. At present, it is a general view that JRA is a systemic and heterogeneityautoimmune disease. With the development of immunology and more studies onthe subgroup of T cell, especially on CD4+T Thl/Th2,it was found that the balanceof Thl and Th2 was an important element in immune response regulation. Helper Tcells are consisted of Thl cell and Th2 cell. Thl cell and Th2 cell could betransformed into each other. In normal state ,they are in balance but when theywere off balance, the immune system will be disturbed that the Th1 cell or Th2 cellwill get advantage over the other, this is called Thl drift or Th2 drift. In general,when the Th1 cell and the cytokines they excrete are dominant, it is called Th1 cellpredominance, n JRA patients, the peripheral tolerance mechanism is confused, Tcell proliferation function will be abnormal, the amount of potentiality autoreactivityT cells will be increased. It has been studied in this study that whether thedisbalance of Th1/Th2 and the changes in activity and silent periodin exist in JRA.In our research ,we use the MTX and Sinomenine traet the JRA. Before treatand being treated,the data is IFN-γ:18.54±3.92pg/ml,11.53±2.42pg/ml,TNF-α:158.60±27.92,119.68±11.55,IL-4: 1.86±0.68pg/ml,2.35±0.72pg/ml。IFN-γ/IL-4: 10±2.15,4.91±1.27。It show that treat well by using this way,andchanging the disbalance of Th1/Th2.It is one of the best way in treating JRA.It's found in this study that the concentration of IFN-γin patients wasincreased very much, which demonstrated that IFN-γwas over excreted, thefactors promoting inflammation were hyperactivity, and IFN-γinduced immunereactions and resulted in synovial membrane damage.IL-4 is a kind ofinflammation inhibition factor, which could inhibit monocyte excreting IL-1,TNF,inducing B cell producing IgG.IL-4 is the only cytokine Th cell produced whichcould transmit the host immune response to humoral immunity, and at the sametime, deviate from cell-mediated immunity. In this study ,the IL-4 level in JRApatients was lower compared with the control, showing that the inflammationinhibition factors were reduced. All these results demonstrated the drift of Thl/Th2to Thl in JRA and the amount of Th1 cell increased which mediated cell-mediatedimmunity, the change of Thl/Th2 ratio and the JRA process was positivecorrelation. There is a relationship between the development of JRA and theinflammatory reaction caused by autoimmune response Thl.
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