ABSTRACT
Objective To investigate the influence of Leptin on the proliferation of peripheral blood regulatory T cells in patients with rheumatoid arthritis (RA).Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 6 RA patients.RA PBMCs were stimulated with anti-CD3 (3 μg/ml)/anti-CD28(2 μg/ml) antibody for 72 h,anti-CD3 (3 μg/ml)/anti-CD28 (2 μg/ml) antibody and Leptin (100 ng/ml) for 72 h,anti-CD3 (3 μg/ml)/anti-CD28 (2 μg/ml) antibody and Leptin (100 ng/ml) and interleukin (IL)-6 receptor antagonist (0.5 μg/ml) for 72 h.Regulatory T cells (Treg) were detected by flow cetometry.IL-6 level and TGF-βlevels in the supernatants of RA PBMCs culture were detected by Enzyme linked immunosorbent assay(ELISA).Statistical analysis between the two groups were performed by Wilcoxon Signed Rank Test.Results ①) Our results suggested that compared to the control group,RA PBMCs were stimulated by leptin for 72 h had lower percentage of Treg[13.6(11.6,14.8)％ vs 9.8(7.0,10.0)％,Z=-2.201,P＜0.05];Compared to the control group,the level of IL-6 and TGF-β were elevated when RA PBMCs treated with leptin for 72 h [548.9(508.6,608.4)ng/L vs 631.8(538.4,672.6) ng/L,Z=-1.992,P＜0.05;1175.0(1 045.4,1 373.1) ng/L vs 1 580.2(1 315.3,1 906.5) ng/L,Z=-2.201,P＜0.05];② The percentage of Peripheral Treg was increased [9.8(7.0,10.0)％ vs 12.3(9.7,13.8)％,Z=-1.997,P＜0.05] and the level of IL-6 was decreased [631.8(538.4,672.6) ng/L vs 522.7(339.3,593.3) ng/L,Z=-2.201,P＜0.05] when RA PBMCs was stimulated with IL-6 receptor antagonist and anti-CD3/anti-CD28 antibody and Leptin for 72 h.Conclusion The study has shown that Leptin can down-regulate the percentage of RA peripheral blood Treg via increasing IL-6 secretion.
ABSTRACT
Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and red blood cell distribution width in discriminating disease activity of rheumatoid athritis.Methods Eighty-nine rheumatoid arthritis out-patients of the Affiliated Hospital of Jiangsu University from Jan.2012 to Mar.2013 were recruited into this study.The disease activity index,such as swollen joint count and tender joint count were made by rheumatologists,and laboratory parameters（blood cell analysis,erythrocyte sedimentation rate and C-reactive protein) were measured as well.The enrolled patients were divided into the active RA group and remission RA group based on the DAS28 definition.Differences of NLR,PLR and RDW among groups were analyzed by t test and relations between variables were assessed by Spearman correlation analysis.The t test,non-parametric test and Spearman analysis were used for statistical analysis.Results The levels of NLR (3.2±2.0,2.4±0.9,respectively) and PLR (167±70,133±43,respectively) in active RA group were higher than that of the RA remission group (t=2.28 and 2.50,P=0.02 and 0.01).The level of RDW [(13.9±2.5)％,(13.9±2.4)％,respectively] was not significantly different between the active RA group and the RA remission group (t=0.14,P=0.89).However,compared with healthy controls,the level of RDW [(13.9±2.5)％,(13.2±0.2)％,respectively] was significantly increased in RA patients (t=2.74,P=0.006 9).NLR and PLR were positively correlated with DAS28 (r=0.23,P=0.03;r=0.26,P=0.04,respectively),ESR (r=0.28,P=0.03;r=0.43,P＜0.01,respectively) and CRP (r=0.33,P=0.006;r=0.41,P＜0.01,respectively).However,there was no association between RDW and DAS28 (r=0.01,P=0.93),ESR (r=0.20,P=0.15) and CRP (r=0.05,P=0.71).Areas under curve of receiver operating characteristic (ROC) for assessing disease activity of rheumatoid athritis by NLR and PLR were 0.802 and 0.753 respectively.The cut-off values for discriminating active/remission RA were 2.86 and 143.05,with the sensitivity as 0.66 and 0.63,specificity as 0.72 and 0.65.Conclusion NLR and PLR are significantly associated with the disease activity of RA and can be useful to understand the activity state of the illness.