Study On BlyS And CD19CD25 B Lymphocyte Subsets In Patients With Rheumatoid Arthritis

Objective:Rheumatoid arthritis (RA) is a familiar chronic and systemic and inflammatory autoimmune disease, in which main clinical features are chronic and symmetric poly-synovium joints inflammation and extra-articular lesions. The etiologocal factor and pathogenesis of RA is uncompletely known. At present, infection, genetic factor, T Lymphocyte, synovial cell and B Lymphocyte are thought to be involved wifh RA. However, the notion of a role for B cells and antibodies in these diseases has gained support through research with experimental animal models. The the recent use of B cell-depleting agents such as Rituximab (anti-CD20) in patients with RA or SLE also emphasizes the important role of B cells in driving several autoimmune disorders.B cells produce pathogenic autoantibo- dies, but also serve as antigen-presenting cells (APC) that under some circumstances may corrupt the normal processes of T cell co-stimulation or activation. Recently, B lymphocyte stimulator (BlyS) has emerged as one of the critical factors controlling B cell homeostasis, tolerance and malignancy.BlyS is critical for B cell survival and maturation that appears to play a critical role in autoimmunity such as RA, systemic lupus erythematosus (SLE) and Sjogren's syndrome(SS). Occasionally, the discovery of CD4~+CD25~+ regulatory T cells may play a role in the pathogenesis of RA, It is report that the over-expression of CD25 on lymphocyte in peripheral blood and synovial fluid of patients with RA might be associated with the pathogenesis of RA, but the report is rare about this aspect.To explore the immunological and patholog- ical of RA, through detecting the level of BlyS in the serum and synovial fluid and the expression of CD19CD25 in peripheral blood of RA patients,and try to do something for finding a new and effective approach to treat RA.Methods: Twenty-four RA patients with knee effusion and twenty cases of normal controls were chosen. All patients were initially treated and never took DMARDs.The RF,ESR,CRP, PLT,IgG,IgA,IgM,C3,C4 and clinical symptoms of RA patients were recorded.The level of BlyS in serum and synovial fluid samples were test with enzyme linked immunosorbent assay (ELISA).And flow cytometry (FCM) wae used to detect the expression of CD19CD25 in peripheral blood.Statistical analysis were made between BlyS, CD19 CD25 and traditional parameters of disease activity(RF, ESR, CRP, PLT).SPSS16.0 was used to processa all data. Quantitative data were expressed as ( x±s). t-test was used for group comparition and linear correlation was used to in correlation. P values of < 0.05 were considered significant.Results: 1 The demographic details: In the group of RA,18 subjects were female and 6 subjects were male, the mean disease duration was (20.1±15.6) months, with a mean age of (51.2±15.9)yr.In 20 normal controls, with a mean age of (40.2±15.7)yr,15 subjects were female,5 subjects were male. There were no differences between the patients and normal controls in age,gender (P>0.05).2 The serum levels of BlyS in different groups: The levels of BlyS in serum of RA group (0.390±0.278)ng/ml were significantly higher than normal controls(0.125±0.035 ng/ml); (P<0.01).3 The synovial fluid levels of BlyS in patients with RA: The synovial fluid levels of BlyS (0.681±0.335)ng/ml were significantly higher than serum (0.390±0.278)ng/ml (P<0.05).4 The Correlation between the serum level of BlyS and laboratory parameters of disease activity (RF, ESR, CRP, PLT,): According to correlation analysis, the serum level of BlyS was significiently correlated with RF ,ESR, CRP and PLT (r=0.710 P<0.01; r=0.541 P<0.01; r=0.603 P<0.01; r=0.681 P<0.01).5 The percentage of CD25+,CD19+ ,CD19+CD25+ in the peripheral blood were (8.814±2.034)%,(10.236±2.212)% and (0.500±0.259)%,which were significantly higher than normal controls (3.233±0.800)%, (6.870±1.052)% and (0.168±0.482)% (p<0.05).Conciusions: 1 The serum levels and synovium levels of BlyS increased significantly in patients with RA. It suggested that BlyS as an inflammatory factor play an important part in the pathogenesis of RA.2 BlyS levels in RA patients were higher in the synovium than in the corresponding serum, suggesting that local produc- tion of BlyS in the synovium drived the maturation of B cells to produce the ectopic lymphoid-like tissue in the pannus of the RA joint.3 The serum level of BlyS significantly increased and had correlation with laboratory parameters of disease activity (RF,ESR,CRP,PLT), that could provide reference to the monitoring of pathogenetic conditions of patients with RA.4 There was significant difference of the percentage of CD25+,CD19+ CD19+CD25+ in the peripheral blood between patients with RA and normal control.5 The test of serum cytokine network may provide theory evidence to the use of biological agents for RA and the development of new drugs.