Plasma and Synovial Fluid TrxR Levels are Correlated With Disease Risk and Severity in Patients With Rheumatoid Arthritis.
Plasma and Synovial Fluid TrxR Levels are Correlated With Disease Risk and Severity in Patients With Rheumatoid Arthritis.
复制标题
血浆和滑液 TrxR 水平与类风湿关节炎患者的疾病风险和严重程度相关
DOI：
10.1097/md.0000000000002543
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发表时间：
2016-02
期刊：
影响因子：
1.6
通讯作者：
Wen C
中科院分区：
文献类型：
--
作者：
Xie Z;Sun J;Li H;Shao T;Wang D;Zheng Q;Wen C
本研究旨在确定中国类风湿关节炎（RA）患者血浆和滑液（SF）中硫氧还蛋白还原酶（TrxR）水平与疾病活动度之间的关系。
本研究共纳入224例确诊为RA的患者、224例年龄和性别匹配的健康对照者以及156例患者对照者。RA患者的疾病活动度通过包含28个关节计数的疾病活动度评分（DAS 28）来计算，并分为低疾病活动度（LDA）组和高疾病活动度（HDA）组。
与健康对照者相比，RA患者血浆中的TrxR水平升高（P < 0.0001）。血浆TrxR的曲线下面积（AUC）为0.874，在诊断RA方面，其鉴别能力明显强于C - 反应蛋白（CRP；AUC为0.815）、抗链球菌溶血素O（ASO；AUC为0.631）、类风湿因子（RF，AUC为0.793）以及红细胞沉降率（ESR，AUC为0.789）。高疾病活动度的RA患者血浆和滑液中的TrxR水平明显高于低疾病活动度患者（P < 0.0001）。血浆TrxR水平作为筛选高疾病活动度的指标，其AUC为0.874，鉴别能力明显强于CRP（AUC为0.690）、ASO（AUC为0.597）、RF（AUC为0.657）以及ESR（AUC为0.603）。同样，滑液TrxR水平作为筛选高疾病活动度的指标，与上述生物标志物相比，也显示出更强的鉴别能力。
血浆和滑液中的TrxR水平与RA的严重程度呈正相关。因此，TrxR水平除了传统生物标志物外，可作为评估RA风险和严重程度的一种新的生物标志物。对TrxR释放机制的进一步分析可能会使我们对RA的发病机制有新的认识。
AbstractThis study was designed and performed to establish the relationship between plasma and synovial fluid (SF) levels of thioredoxin reductase (TrxR) and disease activity in Chinese patients with rheumatoid arthritis (RA).This study consisted of a total of 224 patients diagnosed with RA, 224 age and sex-matched healthy controls, and 156 patient controls. The disease activity of RA patients was calculated as diseases activity score that include 28-joint counts (DAS 28), which was divided into low-diseases activity (LDA) and high-diseases activity (HDA) groups.Increased plasma TrxR was detected in patients with RA than healthy controls (P < 0.0001). With an area under the curve (AUC) of 0.874, plasma TrxR showed a evidently greater discriminatory ability than C-reactive protein (CRP; AUC, 0.815), antistreptolysin-O (ASO; AUC, 0.631), rheumatoid factor (RF, AUC, 0.793), and erythrocyte sedimentation rate (ESR, AUC, 0.789) in diagnosing RA. RA patients with HDA had significantly elevated TrxR levels in plasma and SF than did those with LDA (P < 0.0001). With an AUC of 0.874, plasma TrxR levels as an indicator for screening of HDA showed a significantly greater discriminatory ability than CRP (AUC, 0.690), ASO (AUC, 0.597), RF (AUC, 0.657), and ESR (AUC, 0.603). Similarly, SF TrxR levels as an indicator for screening of HDA also showed a significantly greater discriminatory ability as compared with above biomarkers.TrxR levels in plasma and SF were positively correlated with the severity of RA. TrxR levels may therefore serve as a new biomarker in addition of the traditional biomarkers for assessing the risk and severity of RA. Further analysis of TrxR release machinery may give us a new understanding of pathogenesis of RA.