Variation Of RANKL/OPG In Serum And T Lymphocyte Of Patients With Rheumatoid Arthritis And Their Clinical Significance

Background Rheumatoid arthritis(RA) is a common disease on which synovitis is the major pathology feature. It is a chornic autoimmune disease which can lead destruction of articular cartilage and bone. Destruction of articular cartilage and bone are the primary cause of descending of quality of life and deformity. RANKL/RANK/opg system which play an important role of the bone adjustion has become more and more popular in recent year. Research found RANKL/RANK /OPG system and T cell can partly explain this damage of joint and bone. RANKL/RANK/OPG system is a important association between abnormality of immune system and bone damage of RA.Objective To detect the positive expression level of CD3+mRANK+ cells in the peripheral blood and the level of sRANKL and OPG in serum and culture supernatant of patients with RA, compare the disparities between them and healthy people, analyze correlation between them and disease activity, stage of X ray, AKP, CRP, auto antibody, and other clinical data and laboratory indicators, and investigate the association between RANKL/RANK /OPG system and the destruction of the patients with RA.Methods 24 RA patients and 20 healthy control were collected in the Rheumatology and Immune Department of the First Affiliated Hospital of Anhui Medical University. Extracted the peripheral blood mononuclear cell(PBMC), subsequently stimulated in vitro with PHA for 72 hours, Flow cytometry(FCM) was used to detect the positive expression level of CD3+mRANK+ cells in the peripheral blood, and ELISA was used to detect the level of sRANKL and OPG in serum and culture supernatant. Results1. Inactivated T cell of RA or NC have no significant expression of mRANKL;unactivated or activated T cell have no expression of OPG.2. Expression level of CD3+mRANK+ cells in RA patients compared with that in normal control(NC) group had no statistical significance(P>0.05).3. Compared with normal control(NC) group, the level of sRANKL and OPG and sRANKL/OPG ratio increased in serum of RA patients (p<0.05). Compared with normal control(NC) group, the level of sRANKL and sRANKL/OPG ratio increased in culture supernatant of RA patients (p<0.05). In the some group,compared with culture supernatant,the level of sRANKL and OPG increased in serum of RA patients and normal control (p<0.05).4. Multivariate linear regression showed there was a negative correlation between DAS28 and the level of OPG in serum in RA(β=-0.681, t=3.315, p=0.005).There was a positive correlation between anti-CCP and sRANKL/OPG ratio in serum in RA(β=0.497, t=2.326, p=0.040). There was a negative correlation between mRANKL and the Sharp method(β=0.522,t=2.370, p=0.032). There was a negative correlation between HAQ and the Sharp method(β=0.559, t=2.536, p =0.023).Conclusion1.Whatever RA and normal control inactivated T cell don't express mRANKL;mRANKL is expressed by activated T cell in an later stage.2. OPG,as a secreted glycosidoprotein,membrane-bound OPG is not the main form of OPG.3. SRANKL may be play an more important role than mRANKL in RA. 4. SRANKL/OPG may be more effective than sRANKL for measuring bone destruction of RA.5. Abnormality of RANKL shedding of T lymphocyte may be another inmmune machanism of the bone destruction of RA6. The level of mRANKL expressed by activated T cell is risk factor for the severity of bone damage of RA.7. In the bone destruction of RA , Anti-CCP antibodies and RANKL/RANK /OPG system may be closely related.