The Expression And Clinical Significance Of Annexin A2 In Patients With Systemic Sclerosis

Objective:To explore the expression and clinical significance of annexin A2(ANX A2)in patients with Systemic sclerosis.Methods:Twenty-three patients with SSc admitted to the Department of Immunology and Rheumatology of the Third Affiliated Hospital of Soochow University were selected as experimental group,peripheral blood was collected,four of them underwent biopsy of forearm skin tissue.Sixteen patients matched for age,gender were selected as a control group,peripheral blood was collected,two patients who underwent breast fibroma surgery during the same period were selected as normal controls.Patients were divided into different groups.According to disease duration:early course group(duration<3 years,n=11)and late course group(duration>3 years,n=12);According to the patient's skin lesions:swelling period(n=7),sclerosis period(n=13),and atrophy period(n=3).According to 2016 revised EUSTAR activity index:active group(revised index>2.5,n=11)and non-active group(revised index<2.5,n=12);According to different clinical manifestation:DU group(n=10),non-digital ulcer group(n=13)and PAH group(n=8),non-pulmonary arterial hypertension group(n=15).The expression of ANX A2 in skin tissue samples was determined by immunohistochemical staining.The relative expression levels of ANX A2,VEGF and TF in peripheral blood mononuclear cells(PBMCs)were determined by RT-PCR.The general condition,clinical manifestations,and auxiliary examination results of patients with SSc were collected.The relative expression levels of ANX A2,VEGF and TF were compared between the groups,the correlation between ANX A2,VEGF and TF,clinical and auxiliary examinations was analyzed.Results:(1)Immunohistochemistry showed that ANX A2 was positively expressed in vascular endothelial cells and epidermal cells of normal skin tissues,and strongly expressed in vascular endothelial cells and epidermal cells of patients with SSC in swelling period,and weakly expressed in epidermal cells of skin tissue of patients with SSc in sclerosis-atrophy period.(2)There was no significant difference of ANX A2 and VEGF and TF expression in PBMCs between SSc group and healthy control group(P>0.05).The relative expression level of ANXA2 in PBMCs in swelling period was significantly lower than that in HC group(6.57 vs 14.38,P=0.011)and sclerosis period(6.50 vs 12.65,P=0.024).The relative expression level of TF in PBMCs in sclerosis and atrophic period was significantly higher than that in swelling period(13.31 vs 5.29,P=0.004),(9.00 vs 4.00,P=0.017).There was no significant difference of ANX A2,VEGF and TF expression in PBMCs between late course group and early course group(P>0.05).There was no significant difference of ANX A2,VEGF and TF expression in PBMCs between active group and non-active group(P>0.05).There was no significant difference of ANX A2,VEGF and TF expression in PBMCs between DU group and non-digital ulcer group(P>0.05).There was no significant difference of ANX A2,VEGF and TF expression in PBMCs between PAH group and non-pulmonary arterial hypertension group(P>0.05).(3)There was no significant correlation between the relative expression level of ANX A2 in PBMC of SSc patients and the clinical manifestations and laboratory indexes(P>0.05).(4)The relative expression level of ANX A2 in PBMCs of patients with SSc was positively correlated with the relative expression level of VEGF(P=0.035),and positively correlated with the relative expression level of TF(P=0.027).Conclusion:ANXA2 was abnormally highly expressed in the skin tissue of SSc inswelling period,ANXA2 was lowly expressed in the skin tissue of SSc in sclerosis-atrophic period.The relative expression level of ANXA2 in PBMCs of patients with SSc in sclerosis period was significantly higher than that in swelling stage.The relative expression level of TF in PBMCs of patients with SSc in sclerosis and atrophic period was significantly higher than that in swelling period.The relative expression level of ANX A2 in PBMCs of patients with SSc was correlated with the relative expression level of VEGF and TF,which suggested that ANXA2,VEGF and TF may be related to the occurrence and development of SSc.