| Objective: Rheumatoid Arthritis (RA) is a common rheumatis disease. It's pathological change is chronic synovitis, whith invade cartilage and bone in the lower layer, and joint destruction in the end. It's one of the main cause of losing labor ability and causing disability in our country. However, it's pathgenesis is not obvious. The abnormal expression and network uncontrol of some cytokine (CK) may be one of the important factors of pathgenesis .In the sametime, the fact that adrenocorticotropic hormone (ACTH) is abnormally higer in RA patients has been known by people. Wether a relation exist between them or not has become the new point of RA pathgenesis. In 1980s, Besedovsky first point out the hypothesis of immune-neuro-endocrine network. It changed the traditional understanding of immune system and neuro-endocrine system. The hypothesis point out : neuro-endocrine system play a important role of immune regulation except traditional function, and the immune system is one of the important feel and neuro-endocrine system. It can feel immune change that neuro system can't feel. It has been proved that the role between these two systems is two-direction, not one-direction. But this role is rather complex, and many pathgenesis are not obvious. This point has been added into the research field of autoimmune disease. This researeh is to measure one CK, tumor necrosis factor-α(TNF-α), and one Neuro-endocrine hormone, ACTH, in serum and joint liquid of RA patients, to discuss the relation between them, to understand the relation between immune system and neuro-endocrine system in the course of RA, and to study the pathgenesis of RA.Methods: 1.We chose 110 peonle and divide them into three group:(1) A group:30 new and active RA patients,not be used hormone and immune drug. (2) B group:30 RA patients who has been well diagnosed and cured. (3) C group: health control-20health volunteers. We get 15 big joint liquid (11keen joint liquid, 3 elbow joint liquid, 1shoulder joint liquid). We note the age,the course of disease,the number of joint press pain,the number of joint swollen and so on. 2.We measure TNF-αand ACTH by enzyme linked immunosorbent assay (ELISA). ESR,CRP and RF are measured in lab of the NO.2 hospital of HeBei Medical University. 3. The results are expressed by X±S, and the statistic analyse is used by SPSS(10.0)software. P<0.05 has obvious difference.Results: 1 The result of TNF-αin three group: A group 167.98±57.61pg/ml, B group 99.06±39.21 pg/ml, C group 61.74±20.35 pg/ml. After statistic analyse, we found between A and B group, A and C group, B and C group obvious difference (P<0.05). The result of ACTH in three group: A group896.58±245.17 pg/ml, B group 431.19±208.54 pg/ml, C group525.35±188.82 pg/ml. After statistic analyse, we found between A an B group, A and C group group obvions difference (P<0.05). 2.A B C three group relation analyse: TNF-αand ACTH have relation in new and active RA(r=0.696 p=0.00). But they don't have relation in B and C group. 3. TNF-αin joint liquid of 15 new active RA patients who have big joint liquid: 196.29±41.99 pg/ml, ACTH417.50±124.70 pg/ml .TNF-αand ACTH in joint liquid have relation(r=0.686 p=0.005). TNF-αin serum of these 15 patients is 169.23±48 pg/ml, ACTH is 884.36±27 pg/ml . TNF-αbetween in serum and in joint liquid have obvious difference(p<0.05). ACTH between in serum and in joint liquid have obvious difference(p<0.01). 3.This experiment show TNF-αand ACTH in new and active RA patients are not relation to morning-strong time, the number of joint press pain and the number of joint swollen(p>0.05)., but relation to ESR and CRP (p<0.05). In group A, 23 patients have positive RF. RF has relation to TNF-αand ACTH after relation analyse, and the relation is positive(r=0.785 p<0.05).Conclusion: 1.TNF-αin new and active RA is much higher than remissive RA and health reople, and TNF-αin remissive RA than health reople. TNF-αis important factor in pathgenesis of RA, and its compression relate the disease activity. 2. ACTH in new and active RA is much higher than remissive RA and health peonle, but no difference between remissive RA and health people. ACTH and TNF-αhave obvious positive relation in new and active RA. They become a network in the course of disrase. 3. TNF-αin joint liquid is high, and higher than serum, prove joint system is stronger than whole body, and explain the cause of the main expression of RA is joint. TNF-αand ACTH in joint liquid have positive relation, show immune cell in joint can give anti-inflammation factor to release inflammation reaction. 4. TNF-αand ACTH in serum have positive relation between ESR and CRP, show they can relate the serious situation of diease. They have positive relation between RF , show they have relation between abnormal immune situation of disease.
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