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1.重庆医科大学附属儿童医院风湿免疫科、儿童发育疾病研究教育部重点实验室、国家儿童健康与疾病临床医学研究中心、儿童发育重大疾病国家国际科技合作基地、儿童感染免疫重庆市重点实验室,重庆 400014
2.华中科技大学协和深圳医院儿科,深圳 518038
庞敏,Email:pmin0216@163.com, 研究方向:儿童风湿免疫相关疾病。
唐雪梅,Email:tangxuemei2008@163.com。
收稿:2022-01-05,
修回:2022-02-25,
录用:2022-03-16,
纸质出版:2023-02-28
移动端阅览
庞敏,蔡薇,罗晰文,等.A20及NLRP3基因在幼年特发性关节炎中的表达及临床意义探讨[J].重庆医科大学学报,2023,48(2):124-129.
Pang Min,Cai Wei,Luo Xiwen,et al.Expression and clinical significance of A20 and NLRP3 genes in juvenile idiopathic arthritis[J].Journal of Chongqing Medical University,2023,48(2):124-129.
庞敏,蔡薇,罗晰文,等.A20及NLRP3基因在幼年特发性关节炎中的表达及临床意义探讨[J].重庆医科大学学报,2023,48(2):124-129. DOI: 10.13406/j.cnki.cyxb.003046.
Pang Min,Cai Wei,Luo Xiwen,et al.Expression and clinical significance of A20 and NLRP3 genes in juvenile idiopathic arthritis[J].Journal of Chongqing Medical University,2023,48(2):124-129. DOI: 10.13406/j.cnki.cyxb.003046.
目的
2
比较
A20
及
NLRP3
基因在幼年特发性关节炎(juvenile idiopathic arthritis,JIA)患儿及健康儿童中的表达差异,探讨其在预测JIA患儿生物制剂疗效中的作用。
方法
2
依据2001年国际风湿病学联盟诊断标准,收集68例初诊JIA患儿及同期33例健康儿童外周血提取单个核细胞,采用实时荧光定量PCR(quantitative real-time PCR,qRT-PCR)检测
A20
及
NLRP3
基因mRNA表达水平。依据美国风湿病学会2014年提出的JIA疾病活动度评分,将疾病无活动状态视为临床缓解。比较初诊时
JIA患儿及健康儿童
A20
及
NLRP3
基因mRNA表达水平差异。根据不同治疗选择分为白细胞介素-6受体拮抗剂组、肿瘤坏死因子-α抑制剂组及非生物制剂组,随访两基因表达与治疗6个月后疗效之间的相关性。
结果
2
初诊时,相比于健康对照组,JIA组A20基因表达水平明显降低(
P
=0.039),全身型JIA(systemic JIA,sJIA)组
A20
基因表达水平低于非全身型JIA(non-systemic JIA,non-sJIA)组(
P
=0.005);2组
NLRP3
基因表达未见统计学差异(
P
>
0.05);采用二分类logistic回归分析未发现初诊JIA组
A20
及
NLRP3
基因表达水平与JIA治疗疗效具有相关性(组间比较
P
>
0.05);随访6个月后临床缓解组初诊
NLRP3
基因表达水平低于临床未缓解组(
P
<
0.05),初诊
A20
基因表达在临床缓解组与未缓解组中未见统计学差异(
P
>
0.05)。
结论
2
A20
基因在初诊JIA患儿中表达降低,sJIA组
A20
基因表达水平低于non-sJIA组,
NLRP3
基因低表达JIA患儿治疗缓解率更高,预后可能更好。暂未发现
A20
及
NLRP3
基因水平与JIA治疗效果的相关性。
Objective
2
To analyze the expression of
A20
and
NLRP3
genes in healthy controls(HCs) and those with juvenile idiopathic arthritis(JIA),so as to investigate its role in predicting the efficacy of biological agents in JIA patients.
Methods
2
According to the 2001 International League of Associations for Rheumatology(ILAR) diagnostic criteria for juvenile idiopathic arthritis,33 HCs and 68 children newly diagnosed with JIA were enrolled in the study,and their peripheral blood mononuclear cells(PBMCs) were collected. Quantitative real-time PCR(qRT-PCR) was used to detect the mRNA expression of
A20
and
NLRP3
genes. Inactive disease was regarded as clinical remission(CR) according to the Juvenile Idiopathic Arthritis Disease Activity Score proposed by the American College of Rheumatology(ACR) in 2014. The differences in the mRNA expression level of
A20
and
NLRP3
genes were compared between the newly diagnose
d children and HCs. According to different treatment options,JIA patients were divided into IL-6 inhibitors group,TNF-α inhibitors group and non-biological agents group. The correlations between the expression of these two genes and the efficacy after six months of treatment were analyzed.
Results
2
The expression level of
A20
in JIA group was significantly lower than that in HCs(
P
=0.039). The expression level of
A20
in systemic JIA(sJIA) group was lower than that in non-systemic JIA(non-sJIA) group(
P
=0.005). There was no significant difference in the expression of
NLRP3
gene between the two groups(
P
>
0.05). There was no significant correlation between the expression of
A20
and
NLRP3
gene with the therapeutic efficacy by the binary logistic regression analysis(
P
>
0.05). After six months’ treatment,NLRP3 expression in the CR group was lower than that of the clinical non-remission group(
P
<
0.05),and there was no significant difference in
A20
gene expression between CR group and non-remission group(
P
>
0.05).
Conclusion
2
The expression of
A20
is significantly decreased in children with JIA. The expression of
A20
in sJIA is lower than that in non-sJIA. Low expression of
NLRP3
gene in children with JIA may have a higher treatment response rate and better prognosis. No correlation has been found between the expression of
A20
and
NLRP3
genes and the therapeutic efficacy of JIA yet.
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