期刊
CLINICAL RHEUMATOLOGY
卷 25, 期 4, 页码 448-452出版社
SPRINGER
DOI: 10.1007/s10067-005-0106-0
关键词
arthritis; disease activity score; interleukin; synovial fluid; tumor necrosis factor alpha
类别
The aim of the study was to evaluate the clinical significance of serum (S) and synovial fluid (SF) interleukin (IL)-18, IL-15, IL-12 and the tumor necrosis factor alpha (TNF-alpha) measurements in relation to laboratory and clinical measures of disease activity of patients with active rheumatoid arthritis (RA). Sixty-four patients with RA and 25 patients with osteoarthritis (OA) were included in this study. RA activity was determined using the Disease Activity Score (DAS) 28 index. Concentrations of IL-18, IL-15, IL-12 and TNF-alpha were measured by ELISA. Serum C-reactive protein (CRP) levels were also determined. Cross-sectional correlations between S and SF levels of cytokines and values of DAS 28 index were calculated. The results have shown that IL-18, IL-15, IL-12 and TNF-a levels in S and SF of patients with RA were significantly higher than the levels obtain from patients with OA (p < 0.01). Significantly higher levels of IL-18, IL-15 and TNF-a were found in the SF compared to the S of patients with RA (p < 0.01). Significantly higher S and SF levels of all four cytokines and serum CRP values were found in RA patients with high disease activity (DAS 28 > 5.1) compared to those with mild (DAS 28 > 3.2) and low disease activity (DAS 28 > 2.6) (p < 0.01). Serum and SF concentrations of all four cytokines positively correlated with DAS 28 index values, i.e., disease activity. A poor correlation was found for S and SF IL-12 whereas the highest coefficient of correlation was found for SF IL-18 (r =0.879, p < 0.01), and SF TNF-alpha (r=0.827, p < 0.01) and disease activity in this study. Strong correlation was found between SF TNF-alpha, and SF IL- 18 levels (r =0.73 2, p < 0.01). In conclusion, SF IL- 18 and TNF-a levels in RA patients are good indicators of disease activity. The results obtained support the use of the DAS in clinical practice as a reliable method in assessing disease activity in RA patients.
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