Expression Of Tissue Factor In Patients With Rheumatoid Arthritis And Its Clinical Significance

Objective:To explore the expression and clinical significance of tissue factor?TF?in peripheral blood and tissue of Rheumatoid Arthritis?RA?patients.Methods:Peripheral blood mononuclear cells?PBMCs?of 75 RA patients?RA group?which includes 14 patients self-paired as before(RA₀ group)and after treatment(RA₁ group)and 46 age-and sex-matched healthy donors?healthy control group,NC group?were collected.Patients in RA group were further divided into two groups:RA patients of DAS28 scores>3.2 were assigned into the RA-active group and these of DAS28 scores?3.2 were the RA-inactive group?RA-low activity and clinical remission?.The expression of TF mRNA in PBMCs was determined by qPCR.Seven Knee joint synovial tissue samples from five diagnosed RA patients,one Osteoarthritis?OA?patient and one trauma patient were collected,and the expression of TF in the Knee joint synovial tissue samples were determined through immunohistochemical staining.The statistical significance was analyzed via Mann-Whitney U test,one way ANOVA,Kruskal-Wallis H test,and Spearman's correlation.Results:?1?The 75 RA patients consisted of 61 female patients?81.33%?and 15male patients?18.67%?,and the median value of age was 60;The 14 patients self-paired as before and after treatment consist of 2 male patients?85.27%?and 12 female patients?14.29%?;The 45 RA-active patients contained 36 women?80.00%?and 9 men?20.00%?,which their ages were from 38 to 76,the median value of age was 57.?2?The relative expression level of TF mRNA in PBMCs of RA patients 1.32?0.08,13.03?was significantly higher than that of the healthy control group 0.76?0.07,4.53?,the statistical P value was0.018;The relative expression level of TF mRNA in PBMCs of the RA₀ group2.07?0.31,13.03?was significantly higher than that of the RA₁ group 0.79?0.08,4.12?,the statistical P value was 0.039;The expression of TF mRNA in PBMCs of RA-active patient1.63?0.13,13.03?was significantly higher than that of the RA-inactive patients0.77?0.08,10.55?and healthy donors 0.76?0.07,4.53??P=0.037and P=0.012?;However,there was no statistical difference of TF mRNA expression in PBMCs between RA-inactive patients and healthy donors?P>0.05?.?3?The expression level of TF mRNA expression in PBMCs of the RA-active patients was positively correlated with the laboratory indicator results of erythrocyte sedimentation rate?ESR?,hypersensitive C-reactive protein?hs-CRP?,C-reactive protein?CRP?,D-dimer?D-D?and plasma fibrinogen?FIB?significantly?P<0.05?;Further,the expression level of TF mRNA in PBMCs of the RA-active patients was positively correlated with the clinical manifestations of interstitial lung disease,lymphadenectasis,heart diseases,the coronary atherosclerosis for example,and the DAS28 scores?P<0.05?;However,the correlation between TF mRNA expression in PBMCs of RA-active patients and the anti-cyclic citrullinated peptide antibody?anti-CCP?,the plasma prothrombin time?PT?,and the activated partial thrombin time?APTT?respectively shows no statistical significance?P>0.05?.?4?The immunohistochemical analysis of Knee joint synovial tissues from different patients showed that TF expression was positive in lymphocytes,synoviocytes,vascular endothelium,and pannus of four synovial tissues with RA,While in the Knee joint synovial tissue of the OA patient and the other one of the RA patients,the expression of TF was only observed in lymphocytes,synoviocytes,and vascular endothelium.There was no obvious pannus structure observed in these two tissue samples.In the Knee joint synovial tissue sample from trauma patient,there was no significant TF expression observed in the synovial cells,vascular endothelium and lymphocytes.Conclusion:TF shows abnormal expression in the peripheral blood mononuclear cells and knee joint synovial tissues of RA patients and related to disease activity indicators,which suggested that TF may participate in the occurrence and development of RA.