Research On The Expression Of Survivin In Serum And Synovial Tissue Of Patients With Refractory Rheumatoid Arthritis

Objective:To detect the Survivin expression of serum and synovial tissue in normal control group, rheumatoid arthritis in untreated group, effective treatment group and the refractory group and explore the relationship between Survivin and the multidrug resistance of RA.Method:20normal control group and60RA patients (20untreated,20effective to treatment and20refractory group) were selected based on the standard of enrollment. The concentration of serum Survivin in the four group were measured by Enzyme-linked immunosorbent assay,and the clinical feature、laboratory test results, for example:the number of swollen joints、blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were recorded; The expression of Survivin in synovial tissue of51samples of the four groups were tested by immunocytochemical technique. SPSS16.0statistical software was used to analyze the differences between the data of each group. Result:1.The concentration of serum Survivin was significantly higher in RA untreated group than that in the normal control group (257.18±17.32pg/ml vs116.68±19.07pg/ml, P<0.05) and RA treatment effective group(257.18±17.32pg/ml vs127.37±11.42pg/ml, P<0.05)2. The concentration of serum Survivin was significantly higher in RA refractory group than that in the normal control group(270.04±23.03pg/ml vs116.68±19.07pg/ml, P<0.05) and RA treatment effective group(270.04±23.03pg/ml vs127.37±11.42pg’ml, P<0.05)3.The concentration of serum Survivin was higher in RA refractory group than that in RA untreated group(270.04±23.03pg/ml vs257.18±17.32pg/ml), but there were no significant differences between them(P>0.05)4.The concentration of serum Survivin in RA refractory group showed a significant positive correlation with the number of tenderness joints、the time of DMARDs drug use、ESR、anti-CCP antibodies and DAS28score, but no relationship was found with age、course of disease、 VAS score, number of swollen joints,blood count, rheumatoid factor (RF), CRP, globulin (GLO) and so on.5.The positive rate of Survivin of Synovial tissue was significantly higher in RA untreated group than that in the normal control group and RA treatment effective group (P<0.05); 6.The positive rate of Survivin of Synovial tissue was significantly higher in RA refractory group than that in the normal control group and RA treatment effective group (P<0.05);7.The positive rate of Survivin of Synovial tissue was higher in RA refractory group than that in RA untreated group, but there was no significant differences (P>0.05);8.The cells of the synovial lining layer, sublining inflammatory cell infiltration of the RA early untreated group,RA treatment effective group,RA refractory group were all expressed survivin, all the groups showed no significant difference in expression site (P>0.05).Conclusion:1. Survivin expressed higher in serum and synovial tissue of RA patients than normal control group.2. The serum and synovial tissue expression of Survivin in RRA group was significantly higher than the treatment of effctive RA patients, prompt the high expression of Survivin may be an important part of multidrug resistance of RA.