Analysis Of CD4~+T Lymphocyte Subsets And Cytokines In Peripheral Blood Of Patients With Rheumatoid Arthritis And Interstitial Lung Disease

Objective:1.Analysis of the characteristics of CD4~+T lymphocyte subsets,laboratory tests,and cytokines in peripheral blood of patients with rheumatoid arthritis(RA)and interstitial lung disease(ILD).2.To explore the role of CD4~+T lymphocyte subsets and cytokines in RA with ILD,and provide new methods for disease prevention and treatment.Methods:1.The clinical data of peripheral blood CD4~+T lymphocyte,ESR,CRP,Das28,Rheumatoid factor and autoantibodies were collected from 84 RA patients with ILD(RA-ild1 group)and 81 RA patients without ILD(RA1 group),Collect CD4~+T lymphocyte subsets from peripheral blood of 80 healthy controls(HC).Kruskal Wallis H rank sum test was used to compare and analyze CD4~+T lymphocyte subsets in RA-ILD1,RA1,and HC groups.Wilcoxon rank sum test was used to compare and analyze clinical data such as erythrocyte sedimentation rate,C-reactive protein,DAS28 scores,rheumatoid factors,and autoantibodies in RA-ILD1 and RA1 groups.2.Collect peripheral blood cytokines from 60 RA patients with ILD(RA-ILD2 group)and 64 RA patients with simple RA(RA2 group).Wilcoxon rank sum test was used to compare and analyze the cytokines in RA-ILD2 group and RA2 group.The difference was statistically significant with P<0.05,and was analyzed using SPSS 25.0 statistical software.Results:1.Compared with RA1 group,Th17 and Th1 in peripheral blood CD4~+T lymphocyte subsets in RA-ILD1 group were significantly higher(both P<0.05).2.The levels of Th17(P<0.001),Th17/Treg(P<0.001),Th1(P<0.001),Th1/Th2(P<0.01)in RA-ILD1 group were significantly higher than those in HC Group,while the levels of Th17(P<0.01)and Th17/Treg(P<0.001)in RA1 group were significantly higher than those in HC Group,Treg was significantly decreased(P<0.01).3.Compared with RA1 group,RA-ILD1 group had significantly higher disease activity indicators such as ESR(P<0.05)、CRP(P<0.05)、DAS28评分(P<0.01)、RF-Ig A(P<0.01)、RF-Ig G(P<0.01)and RF-Ig M(P<0.01).4.In RA-ILD1 group,anti-CCP antibody(P<0.01)、APF(P<0.001)、AKA(P<0.01)and ANA(P<0.05)were significantly higher than those in RA1 group.5.IL-2 and IL-4 levels in RA-ILD2 group were significantly higher than those in RA-2 group(both P<0.05).Conclusion:1.Compared with patients with RA alone,patients with RA-ILD have a significant increase in peripheral blood Th17,suggesting that an increase in Th17 may promote the development of RA related ILD,indicating that the mechanism of immune imbalance plays an important role in the development of RA combined with ILD.2.Compared with patients with RA alone,patients with RA-ILD have significantly higher levels of peripheral blood cytokines IL-2 and IL-4,suggesting that IL-2 and IL-4may play a promoting role in the development of RA related ILD.3.Disease activity related indicators in RA ILD patients are significantly higher than those in RA patients alone,indicating that disease activity is one of the main factors in the occurrence and development of RA combined with ILD.High titers of anti CCP antibodies also play an important role in RA related ILD processes.