| ObjectiveAnalysis of juvenile ankylosing spondylitis peripheral blood T lymphocyte subsets and related cytokine changes in the characteristics and clinical significance, discusses its relationship with the occurrence and development of disease and mechanism of action, and explore and screening the related biomarkers for early diagnosis, assessment of disease progression and the index of activity.MethodsChoice in July2009to September2009in my the inpatient and outpatient diagnostic cases with complete data of children with juvenile ankylosing spondylitis (JAS)33cases.Diagnostic criteria according to the international alliance of rheumatology diagnostic criteria of the new classification of childhood rheumatic diseases, and refer to Guiying Shi conclusion ankylosing spondylitis nine children reference standard.Including25male and8female, male and female ratio is3.1:1;5-14years old, average9.2years old;Course of3months to3years;Are ruled out growth pain, excessive activity history, family history of psoriasis;Ankylosing spondylitis (AS) a family history of9cases. Selection in our hospital pediatric outpatient medical examination of20cases of healthy children as control group.Using flow cytometry instrument group and healthy control group in patients with JAS peripheral blood T lymphocyte subsets CD3+T, CD4+T and CD8+T proportion and CD4+/CD8+ratio of testing;Using double antibody enzyme-linked immune clip art (ABC-ELISA) to detect the serum of each subgroup main effect factor il-6, TNF, IL-12-4A level, the difference was statistically significant cytokines with Spearman close analysis of the test its relevance to the juvenile ankylosing spondylitis disease activity.The experimental data are combined with factors influencing group carries on the statistical analysis, to explore lymphocyte subgroup the indicators and related cytokines involved in the mechanism of JAS and meaning.The experimental data using SPSS13.0statistical software analysis.All measurement data are expressed in (x+s);T test to compare the differences between two groups of variables, using Spearman rank correlation method to analyze the correlation between variables;Do not conform to normal distribution and homogeneity of variance is used rank and inspection.Inspection level a=0.05, P<0.05for the difference is statistically significant, P<0.01for the difference is obvious.Results1. Children with JAS group and control group in the expression of peripheral blood T lymphocyte subsets in comparisonJAS patient’s CD4+T lymphocyte percentage and the ratio of CD4+/CD8+were significantly higher than healthy control group, significant difference (P<0.01);CD8+T lymphocytes percentage significantly lower than the healthy control group (P<0.05);CD3+T lymphocyte percentage is lower than the healthy control group, there was no statistically significant difference (P>0.05).2. Children with HLA, B27positive JAS group compared with HLA B27-negative is a group of childrenHLA B27positive JAS with CD4+T lymphocyte percentage higher than children of HLA B27-feminine, difference have statistical significance, T lymphocyte subgroup other no significant differences between the two.3. According to the illness progress JAS with all groups the expression of peripheral blood T lymphocyte subsets in comparisonJAS children early in the peripheral blood T lymphocyte subsets changes, CD3+T and CD8+T lymphocytes is on the decline, the percentage of CD4+T lymphocyte and the percentage of CD4+/CD8+ratio is on the rise, and with the progress of the disease, a trend that more and more obvious.But need to pay attention to is that JAS children early CD4+T lymphocyte percentage is lower than the control group.4. Related cytokine TNF-a T lymphocytes, IL-4, IL-12in different disease activity expression level comparisonTNF-a in children with JAS in the control group, the stability and activity in the serum level is on the rise, the difference between activity and the control group was statistically significant (P<0.05);JAS activity and stability level of IL-4children were significantly lower than the control level, P<0.05, while the activity decreased more significantly, P<0.01, activity levels below the stability, but there was no statistically significant difference between the two;IL-12levels in children with JAS in the control group, low stability and activity levels in the serum has a rising trend, but the differences between each group data without statistical significance.5. TNF-a, IL-4CRP, ESR and correlation with disease activityJAS patients serum TNF-a level and disease activity index (ASDAS) and CRP were positively correlated;IL-4levels and disease activity index (ASDAS) into a significant negative correlation (r=0.6467, P<0.01), and negatively correlated with inflammation activity index ESR (r=0.308, P=0.308), but no obvious correlation with CRP. The level of IL-4change high and low ability to distinguish JAS disease activity is superior to the ESR and CRP.Conclusion1.disease early children with peripheral immune function is low, is not conducive to effective self tolerance, is one of the mechanisms of JAS onset;2.T cell subsets disorder dominated by CD4+T lymphocytes hyperfunction is JAS disease development at the core of the immune mechanism;Suppress the immune function of weakening play an important role;3. The level of TNF-a and IL-4were significantly associated with JAS disease activity, more effectively reflect the JAS occurrence and progression. |
