The Expression Level Of Serum SICAM-1,sVCAM-1and MCP-1in Patients With Raynaud’s Phenomenon Secondary To Connective Tissue Disease

Objective: Soluble intercellular adhesion molecule-1,soluble vascularcell adhesion molecule-1belongs to the immunoglobulin super familymember.They are playing an important role in the pathophysiology ofinflammatory reaction.Under normal circumstances they are not expressed orrarely expressed, but in the induction of cytokines and inflammatory mediators,they can increased expression in endothelial cells.Monocyte chemoattractantprotein-1is the member of the CC chemokine subfamily, which can activateof monocytes-macrophage to produce inflammatory cytokines and causeinflammation.Raynaud’s phenomenon due to a cold or nervous stimulation,acral fine arterial spasm, fingers or toes skin suddenly appeared pale, appearedin succession skin turned purple, red, with partial hair cold, sensoryabnormalities and pain, such as short-term clinical phenomenon. Raynaud’sphenomenon can be the first symptom of many rheumatic diseases.After a fewmonths, years or even decades,many patients with Raynaud’s phenomenon canbe developed for a specific connective tissue disease.Raynaud’s phenomenoncan not only occur in the limbs, but aslo in the important organs.The patientswith Raynaud’s phenomenon of connective tissue disease are more susceptibleto heart, lung, central nervous system involvement. Therefore, for thetreatment of Raynaud’s phenomenon is particularly important, but because thepathogenesis of Raynaud’s phenomenon is not yet very clear, it is nocure-related. Clinically, reducing the number of attacks and relieving thesymptomatic is the mainly treatment. Vascular Endothelial dysfunction isrecognized for the pathophysiological basis of Raynaud’sphenomenon.sICAM-1, sVCAM-1, MCP-1,as the important factor toresponse the function of endothelial cells, had been more researched in the areas of cardiovascular, diabetes, and a certain rheumatic diseases.But it isstudied very little in Raynaud’s phenomenon secondary to connective tissuedisease.This project aims at using ELISA method to detect the expressionof serum sICAM-1, sVCAM-1, MCP-1to further exploring the pathogenesisof Raynaud’s phenomenon secondary to connective tissue disease, therebyproviding help for clinical treatment.Methods:1CTD with RP group:30cases of hospitalized patients with Raynaud’sphenomenon secondary to connective tissue disease;CTD without RPgroup:30cases of hospitalized patients with non-Raynaud’s phenomenon ofconnective tissue disease; healthy control group:30cases of normal person inthe health examination center of the Second Hospital of Hebei MedicalUniversity.There were no cardiovascular and cerebrovascular diseases,diabetes and other medical history of all the subjects, not receiving hormonesand immunosuppressive therapy and infection.2All the subjects are in4ml collecting venous blood into a test tube inthe morning on an empty stomach,centrifuge10min3000r/min, drawing onserum injection tube-20℃cryopreservation, a batch determination.Applica-tion of ELISA was used to detect the expression of serum sICAM-1,sVCAM-1, MCP-1. Also recording the clinical manifestations: skin rash, jointpain, difficulty breathing, palpitations, convulsions. Auxiliary examination:blood routine, urine routine,ESR,24hour urinary protein quantitative, liverfunction, kidney function, immune globulin, complement, antinuclearantibodies, anti-ENA antibodies, anti-ds-DNA, ECG, echocardiography(measured pulmonary pressure) chest CT (interstitial lung disease).3Statistical analysis: SPSS13statistical software was used for dataprocessing and analysis.The general data were expressed with (x±s), Themultiple independent samples are compared using rank sum test (H test).Thetwo independent samples are compared using rank sum test (U test).The countdata is compared using chi square test. Analysis of the correlation betweentwo variables using Spearman correlation analysis. P<0.05was considered statistically significant.Results:1There are30cases in CTD with RP group,including20cases withsystemic lupus erythematosus,4cases with systemic sclerosis,3cases withmixed connective tissue disease,2cases with primary Sjogren’s syndrome,1case with dermatomyositis,3males and27females,aged17to72years,andthe mean age was (38.07±12.49)years old.There are30cases in CTD withoutRP group,including19cases with systemic lupus erythematosus,5cases withprimary Sjogren’s syndrome,4cases with mixed connective tissue disease,2cases with dermatomyositis,4males and26females,aged15to69years, andthe mean age was（37.43±13.73）years old.There are30cases in the healthycontrol group including2males and28females,,aged22to56years,and themean age was（35.93±10.92）years old.There were no differences in the ageand gender among the three groups(P>0.05).2The expression level of serum sICAM-1in CTD with RP group was(706.75±57.72)ng/ml,which was higher than CTD without RP group(646.32±79.08)ng/ml and healthy control group(203.48±46.62)ng/ml, with astatistically significant difference(P<0.05);The expression level of serumsICAM-1was higher than that in healthy control group, with a statisticallysignificant difference(P<0.05).3The expression level of serum sVCAM-1in CTD with RP group was（372.72±43.84） ng/ml, which was higher than CTD without RPgroup(333.98±44.82)ng/ml and healthy control group(116.36±25.09)ng/ml,with a statistically significant difference(P<0.05);The expression level ofserum sVCAM-1was higher than that in healthy control group, with astatistically significant difference(P<0.05).4The expression level of serum MCP-1in CTD with RP groupwas(174.49±37.57)pg/ml, which was higher than CTD without RPgroup(145.40±43.30)pg/ml and healthy control group(61.19±13.38)pg/ml,with a statistically significant difference(P<0.05);The expression level ofserum MCP-1was higher than that in healthy control group,with a statistically significant difference(P<0.05).5There are positive correlations between serum sVCAM-1and MCP-1、sICAM-1and sVCAM-1, and sICAM-1and MCP-1in patients withRaynaud’s phenomenon secondary to connective tissue disease.Correlationcoefficient were respectively0.592,0.618,0.546(P <0.05).6In patients with Raynaud’s phenomenon secondary to connective tissuedisease the incidence of skin rash, hair loss, increased IgG, ILD, PAH, cardiacinvolvement, CNS involvement, anti-U1RNP positive is higher than that innon-Raynaud’s phenomenon of connective tissue disease patients(P<0.05), thedifference was statistically significant; whereas the incidence of injoint pain,ESR increased, leukocyte reduced, platelets reduced, C4reduced, C3reduced,antinuclear antibodies positive, anti-ds-DNA antibody positive is no differencebetween the two groups (P<0.05), the difference was not statisticallysignificant.Conclusions:1The expression level of serum sICAM-1、sVCAM-1、MCP-1in patientswith Raynaud’s phenomenon secondary to connective tissue disease is higherthan the non-Raynaud’s phenomenon of connective tissue disease patients andhealthy control group, this result pointed at that sICAM-1、sVCAM-1、MCP-1may be involved in the pathogenesis of Raynaud’s phenomenon secondary toconnective tissue disease。2The expression level of serum sICAM-1、sVCAM-1、MCP-1in patientswith Raynaud’s phenomenon secondary to connective tissue disease had apositive correlation, adhesion molecules and chemotactic factors in thepathogenesis of secondary Raynaud’s phenomenon with connective tissuedisease may have synergistic effect.