| Objective In order to evaluate the role of survivin level in the pathogenesis of rheumatoid arthritis (RA) and the joint erosivity,the serum level of survivin and other factors in RA patients were investigated, and the relationship between survivin and other clinical and laboratory findings were analyzed simultaneously.Methods The serum of 64 RA patients and 20 healthy controls were collected. Based on the activity index of RA, the 64 RA patients were divided to active RA group,inactive RA group and on the ACR diagnostic criteria and joint damage in patients with X-ray stage,they were divided to erosive RA group,nonerosive RA group.The concentration of serum survivin in the RA patients and healthy controls was measured by sandwich enzyme-linked immunosorbent assay(ELISA).Simultaneously,The clinical feature,laboratory index like rheumatoid factor (RF),anti-cyclic citrullinated peptide (CCP) antibody, anti-perinuclear factor (AKA), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), immunoglobulin (IgG, IgA, IgM) and blood cell count,the number of painful joints,the number of swollen joints, X-ray stage of joint damage and disease activity score 28 were recorded.SPSS17.0 statistical software was used to analyze differences between the data of each group.Results1.The concentration of serum survivin was significantly higher in RA patients than that in the healthy controls.(307.54±137.43 pg/mL vs 105.22±34.86 pg/mL,χ2= 21.69,P<0.01).2.There was no difference in the concentration of serum survivin between the active RA patients and the inactive RA patients.(324.72±141.59 pg/mL vs 265.92±113.81 pg/mL),χ2=0.59,p>0.05).3.The concentration of serum survivin was higher in the erosive RA patients than that in those non-erosion RA patients (380.68±97.21 pg/mL vs 161.26±73.96 pg/mL,χ2=15.68,P<0.01).4. There was no difference in the concentration of serum survivin between non-erosion RA patients and the healthy controls. (161.26±73.96 pg/mL vs 105.22±34.86 pg/mL,x2=1.91, P>0.05). 5.The concentration of serum survivin in the RA patients showed a significant positive correlation with course of disease,C-Reactive Protein (CRP),anti-cyclic citrullinated peptide (CCP) antibody and rheumatoid factor (RF),but no positive relationship was found with Hb,IgG,IgA,disease activity score 28 and so on(P> 0.05).6. The erosive RA patients has a longer course of disease compared with non-erosive RA patient.The concentration of anti-CCP antibodies,RF,ESR and CRP were significantly higher than in non-erosive RA group.The positive rate of AKA is also higher in bone erosion group compared with non-bone erosion.7. The levels of serum survivin of bone erosive RA patients were positively corralated with anti-CCP antibody levels, CRP and WBC.8. Survivin is a potential prognostic factor for the destructive course of disease in RA.There is some further increase in PPV of both survivin and anti-CCP antibodies compared with the single markers.Conclusion1.The concentration of serum survivin in RA patients elevated compared to the controls, which suggested survivin may take part in the pathology of RA.2.The concentration of serum survivin in the active RA patients and the inactive patients has no significantly statistical difference,and showed no correlation with the active index such as ESR,DAS28,the number of painful joints and that of swollen joints, which suggested that survivin may have no relationship with the activity of the disease.3.The concentration of serum survivin was higher in the erosive RA patients than that in those non-erosion RA patients,and that was no difference between non-erosion RA patients and the healthy controls,besides,the levels of serum survivin of bone erosive RA patients were positively corralated with anti-CCP antibody levels, CRP and WBC.It suggested that survivin may be involved in the pathogenesis of RA bone destruction and be related with the severity of disease.4. Survivin is a potential prognostic factor for the destructive course of disease in RA.There is some further increase in PPV of both survivin and anti-CCP antibodies compared with the single markers. |
