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| 膝骨关节炎患者膝关节液中TNF-a、ILs、MMPs、YKL-40的表达 |
| Expression of TNF-a, ILs, MMPs, and YKL-40 in the knee joint fluid of patients with knee osteoarthritis |
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| DOI：10.3969/j.issn.1006-7108.2024.11.004 |
| 中文关键词: 膝骨关节炎 炎性细胞因子 基质金属酶 |
| 英文关键词:knee osteoarthritis inflammatory cytokines matrix metalloproteinases |
| 基金项目:甘肃省自然科学基金（21JR7RA587） |
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| 中文摘要: |
| 目的 研究膝骨关节炎(knee osteoarthritis ，KOA)患者膝关节液中肿瘤坏死因子-a (TNF-a)、白介素 (ILs)、基质金属蛋白酶 (MMPs)、人甲壳质酶-40 (YKL-40)的表达水平，及其与膝关节影像学Kellgren-Lawrence (K~L)分级之间的关系。方法 选取100例行膝关节置换术的KOA患者，根据K~L标准将其分为KL~3级和KL~4级两组。在术前抽取患者的膝关节液，分别采用流式细胞小球微阵列术和ELISA方法检测膝关节液中TNF-a、IL-1b、IL-6、IL-8、IL-15和MMP-3、MMP-9、MMP-13、YKL-40的表达水平。采用两组间比较和单、多因素Logistic回归筛选KL~4的独立影响因素。选择Spearman法分析上述分子与K~L分级之间的相关性。结果 100名KOA患者中男性25名，女性75名，平均年龄64.32岁，平均病程为8.98年。KL~3级55人、KL~4级45人。TNF-a、IL-1b、MMP-13、YKL-40在KL~3中表达较高，IL-6、IL-8、IL-15、MMP-3、MMP-9在KL~4中表达较高。IL-15、MMP-9在两组间的差异具有统计学意义(P<0.05)。单、多因素二元Logistic回归结果显示，IL-15[优势比(OR)=1.575, 95%可信区间(95% CI)：1.286~1.929,P<0.001]和MMP-9(OR=1.032, 95% CI:1.008~1.056，P=0.01)是KL~4的独立危险因素。IL-15 (r=0.220, P<0.05)、MMP-9 (r=0.297, P<0.05)分别与K~L分级之间存在显著的正相关关系。结论 KOA患者膝关节液中IL-15、MMP-9在KL~4级患者中高表达。IL-15和MMP-9是KL~4的独立危险因素，其水平与K~L分级之间存在正相关关系。IL-15与MMP-9有望为临床对该疾病的进展和评估提供参考。 |
| 英文摘要: |
| Objective To investigate the expression levels of tumor necrosis factor α (TNF-a), interleukins (ILs), matrix metalloproteinases (MMPs), and chitinase (YKL-40) in the knee joint fluid of patients with knee osteoarthritis (KOA), and their correlations with Kellgren-Lawrence (K-L) grade of knee imaging. Methods A total of 100 KOA patients undergoing the knee arthroplasty were enrolled and their knee joint fluid was extracted before the joint surgery. The expression levels of TNF-a, IL-1b, IL-6, IL-8, IL-15, and MMP-3, MMP-9, MMP-13, YKL-40 in the knee joint fluid were detected using cytometric bead array and ELISA, respectively. Patients were grouped according to the K-L scores. The independent influencing factors of KL-4 were determined by comparison between the two groups and binary logistic regression. Spearman method was used to analyze the correlations between the above molecules and K-L grades. Results Among 100 patients with KOA, 25 were males and 75 were females. The mean age was 64.32 years and the mean course of the disease was 8.98 years. There were 55 with KL-3 grade and 45 with KL-4 grade. TNF-a, IL-1b, MMP-13, and YKL-40 were highly expressed in KL-3, while IL-6, IL-8, IL-15, MMP-3, and MMP-9 were highly expressed in KL-4. IL-15 and MMP-9 were significantly different between the two groups (P<0.05). The results of univariate and multivariate logistic regression showed that IL-15 [odds ratio (OR) = 1.575, 95% confidence interval (CI): 1.286-1.929; P<0.001] and MMP-9 (OR = 1.032,95% CI: 1.008-1.056, P = 0.01) were independent risk factors for the KL-4. IL-15 (r = 0.220, P<0.05) and MMP-9 (r=0.297, P<0.05) were positively correlated with K-L grades. Conclusion The expressions of IL-15 and MMP-9 in the knee joint fluid of KOA patients are higher than that of KL-4 patients. IL-15 and MMP-9 are independent risk factors for the KL-4. There is a positive correlation between IL-15 and MMP-9 levels and the progression of radiographic K-L grades. IL-15 and MMP-9 may provide references for clinical evaluation and progression of this disease. |
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