Effect of serum interleukin-21 on B cell secretory capacity and apoptosis in patients with systemic lupus erythematosus / 中华内科杂志

Objective To investigate the secretory capacity and apoptosis of interleukin ( IL)-21 induced normal B cells by co-culture with serum from patients with systemic lupus erythematosus (SLE). Methods Serum from twenty new-onset SLE patients and 20 healthy donors were collected .CD1+9 B cells from the normal controls were co-cultured with serum from SLE patients in the presence or absence of IL-21-R-FC(4 μg/ml).Supernatant IgG and IgM concentration were measured by immunoturbidimetric assay on day 5.Supernatant anti-dsDNA level was determined by ELISA .The percentage of apoptotic cells was detected by flow cytometer.Results IgG,IgM and anti-dsDNA levels in normal B cells with SLE serum were significantly higher than those in the serum of SLE patients alone [ ( 5.84 ±1.79 ) g/L vs ( 4.25 ± 1.48)g/L,P=0.000;(0.46 ±0.21)g/L vs (0.43 ±0.21)g/L,P=0.003;(127.76 ±70.24)IU/ml vs (115.15 ±63.88) IU/ml,P=0.014 respectively].However, no significant differences were found in the group of normal B cells with non-homologous serum from normal controls (P>0.05).Supernatant IgG, IgM and anti-dsDNA levels in normal B cells with SLE serum significantly decreased while IL-21R-fusion protein was added [(5.26 ±1.62)g/L vs (5.84 ±1.79)g/L, P=0.006;(0.42 ±0.20)g/L vs (0.46 ±0.21)g/L, P=0.002;( 118.00 ±69.62 ) IU/ml vs ( 127.76 ±70.24 ) IU/ml, P =0.012 respectively ] .The apoptotic rate of B cells with SLE serum was significantly higher than that with normal serum [ ( 47.88 ± 12.65)%vs (38.86 ±10.32)%,P =0.004].But adding IL-21R-fusion conversed the apoptotic rates [(42.08 ±12.52)%vs (47.88 ±12.65)%,P=0.001].Conclusions SLE serum could induce normal B cells to form immunoglobulin secreting cells and producing autoantibodies , or apoptosis in pathological conditions.IL-21 might be considered as a potential therapeutic target of SLE .

The clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis / 基础医学与临床

Objective To analyze the clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis for demonstrating its pathogenesis and for predicting its prognosis. Methods The clinical records of 96 patients with PM/DM were reviewed, focusing on for perdicting its pneumomediastinum. Five patients with pneumomediastinum are described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. Results Five DM cases complicated by pneumomediastinum all had lung infections. Twenty-nine cases (including our five cases) of DM/PM with pneumomediastinum have taken methylprednisolone, four cases alive, and six died. Nine cases have taken CsA,seven cases alive and two died. Conclusion The infections was strongly suspected as being responsible for the pneumomediastinum. Methylprednisolone has poor effect. CsA can be an effective therapeutic agent in PM/DM.

The expression of micro RNA130a on rat bone mesenchymal stem cells during chondrogenic differentiation / 基础医学与临床

Objective To evaluate the role of microRNA130α on rat bone mesenchymal stromal cells(BMSCs)during chondrogenic differentiation.Methods BMSCs were induced to differentiate into chondroeytes by transforming growth factor-β1(TGF-β1)in vitro,immunofluorescence and immunohistochemistry were performed to evaluate MSCs differentiation.RT-PCR was performed to analyze microRNA130α expression at different time points.Results microRNA130α was down-modulated during chondrogenesis after BMSCs been cultured with TGF-β1 for 7 days (P ＜0.05).Conclusion During the early stage of BMSC chondrogenic differentiation,mciroRNA130a expression was specifically repressed,suggesting its role in differentiation of rat bone mesenchymal stromal cells.

Clinical analysis of 45 cases of hemophagocytic syndrome / 基础医学与临床

Objective To analize the clinical features of patients with hemophagocytic syndrome (HI'S). Methods The underlying diseases, clinical characteristics, laboratory findings, responses to therapy as well as their outcomes of 45 patients with HPS were analyzed retrospectively. Results The underlying diseases included virus infection (n = 9) , tuberculosis (n =2), rheumatic fever (n =4) , malignancies (n =22) , unknown diseases (n =8). HPS was clinically characterized by high fever(93. 3% ) , hepatomegaly (77. 8% ) , splenomegaly(80% ) , lymphadenopathy (55. 6% ) , skin rash(24.4% ), gastrointestinal hemorrhage(22. 2% ) , renal (35. 6% ) and central nervous systern involvement( 15. 6% ) , five patients presented with disseminated intravascular coagulation( DIC) (11. 1% ). Laboratory data mainly manifested with cytopenia ( 100% ) , liver dysfunction ( 77. 8% ) , hypofibrinogenemia (62. 8% ), hypertriglyceridemia (71. 1% ) , serum ferritin >500 p,g/L(87. 5% ) , low NK-cell activity(92. 9% ) and hemophagocytosis in bone marrow (100% ). Based on treating underlying diseases and use of corticosteroids and immunosuppressive agents in combination with intravenous immunoglobulins(IVIG) therapy, 14 patients recovered , 19 patients died in the hospital, and other 12 cases give up treatment be cause of exacerbation of the disease.Conclusion There are various underlying diseases and clinical manifestations for HPS. HPS is always extremely dangerous with high mortality. Treatment of underlying diseases, corticosteroids, immunodepressant and IVIG may improve the prognosis of HPS.

A study of T cell recombination excision circles levels in peripheral blood mononuclear cells of systemic lupus erythematosus patients / 中华内科杂志

Objective To compare the T cell receptor recombination excision cycle (TREC) levels in peripheral blood mononuclear cells (PBMC) of systemic lupus erythematosus (SLE) patients with normal age- and gender- matched controls. To investigate the correlations between TREC levels of SLE patients and their clinical features. Methods We studied TREC levels in peripheral blood mononuclear cells (PBMC) of 21 SLE patients and 22 normal age- and sex- matched controls. TREC concentration was determined by real-time quantitative polymerase chain reaction (real-time qPCR) as the number of TREC copies/1000 PBMCs. The clinical features of the SLE patients such as systemic lupus erythematosus disease activity index (SLEDAI) , ESR, C reaction protein (CRP) , ANA, anti-dsDNA and complement levels and organ involvement were recorded and assessed. Results SLE patients had lower TREC levels [ (9.6 ± 7.5 )copies/1000 PBMC] than controls[ (16.1 ±11.1) copies/1000 PBMC,P = 0.033]. There was an inverse correlation between age and TREC levels in controls (r =- 0. 614, P = 0. 002) but not in SLE patients.There was an inverse correlation between SLEDAI and TREC levels in SLE patients(r =-0. 656, P =0. 001) and TREC levels seemed to have relations to skin lesions ( r = - 0. 620, P = 0. 003 ). No other clinical association was observed between TREC levels and clinical and laboratory SLE manifestations.Conclusion SLE patients had lower TREC levels than normal controls and there is a tendency that TREC level is reversely correlated with disease activity. The decrease PBMC TREC level is indicative of a low proportion of recent thymic emigrant (RTE) in SLE and could be caused by decreased RTE output and/or by increased peripheral T cell proliferation in this disease. The under-representation of RTE in the peripheral T cell pool may play a role in the immune tolerance abnormalities observed in SLE.

The soluble expression and identification of single-chain fragment V antibodies against SSA antigen epitopes from the pHEN2 phagemid library / 中华内科杂志

Objective To obtain the soluble single-chain fragment V (ScFv)monoclonal antibodies (McAbs) against the SSA antigen epitopes.Methods Three octapeptides (60 000 SSA antigen residues 482-493 termed as P1 epitope, residues 310-323 termed as P2 epitope and residues 230-241 termed as P3 epitope) were synthesized on the lysine frame.The McAbs were panned by coating the corresponding as targets.The specificity, affinity and gene squences of the positive clones were assessed.Soluble single-chain fragment V antibodies special for SSA antigen epitopes were expressed and then identificated.Results After 5 rounds of panning, reactive scFv clones contained full-length scFv antibodies coding regions were obtained,with sufficient affinity and specificity for respective antigen peptides.The absorbance values at 410 nm of the fusion protein of anti-P1-P3 activity with the corresponding peptides were 1.43 ± 0.23, 0.82 ±0.31 and 0.80 ± 0.25, and there was also statistically significant difference in the cross reactions ( P ＜ 0.01 ).Three clones were successfully expressed and then purified by His-bind resin.The activity in vivo of soluble ScFv antibodies was identified to be positive by the indirect immune-fluorescence assay on Hep-2 cells.Conclusion Souble ScFv McAbs against corresponding SSA antigen peptides with high affinity,specificity and activity in vivo were obtained, which are to be competent enough for epitopes expression on the target organs.

Phenotypic difference between CD4+CD25-Foxp3+ and CD4+CD25+Foxp3+ T cells and its clinical relevance in patients with untreated new-onset lupus / 中华风湿病学杂志

Objective To compare the phenotypes of abnormal CD4+CD25-Foxp3+ T cells with traditional regulatory T cells (CD4+CD25+Foxp3+) in patients with untreated new-onset lupus (UNoL) and investigate their clinical relevance. Methods The expressions of surface markers (CD25, CD127, CCR4, GITR, CTLA-4) and intracellular marker(Foxp3) on the peripheral blood mononuclear cells from twenty-two UNoL patients were analyzed by flow cytometry analysis, and their clinical relevance were assessed. Results There were no significant differences between CD4+CD25-Foxp3+ and CD4+CD25+Foxp3- T cells in the expressions of GITR, CTLA--4 and CCR4 (P>0.05), but they were significantly lower than those of CD4+CD25+ Foxp3+ T cells in UNoL patients (P<0.01). The percentages of CD127low- in CD4+Foxp3+CD25high,CD4+Foxp3+ CD25low and CD4+Foxp3+CD25+ T cells were (93.8±3.5 )%, (93.7±2.3)% and (92.0±2.1)% respectively (P> 0.05), whereas the expressions of Foxp3 on CD4+CD127low- T subpopulations showed significant differences in CD4+CDI27low-CD25high (91.4±2.6)%, CD4+CD127low-CD25low (71.9±3.3)% and CD4+CD127low-CD25- (9.0± 2.2)% T cells(P<0.01 ). The frequency of CD+CCR4+CD25high T cells correlated negatively with SLEDAI (r=-0.695,P<0.001).and it was significantly lower in lupus nephritis patients(1.10±0.17)%compared with SLE patients without nephritis [(1.61±0.23)%,P<0.01]and healthy controls [(1.75±0.10)%,P<0.01], furthermore,the frequency of CD4+CCR4+CD25low-T cells in lupus nephritis was significantly higher than that in healthy controls[(11.5±2.3)%vs (8.0±1.0)%,P<0.01].Conclusion The increased CD4+CD25-Foxp3+ T cells in the Untreated Newonset Lupus(UNoL)patients mimic activated T effector cells.CD4+CD25high-CD127low-T cells can be used to isolate live CD4+CD25highFoxp3+regulatory T cells.CCR4+regulatory T cells may be involved in the pathogenesis of lupus nephritis.

The effect of p53 expression in fibrablast-like synaviocytes on CD4+ T lymphocytes in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate that p53 expression in fibroblast-like synoviocytes (FLS) and its effects on CD4+ T lymphocytes from active rheumatoid arthritis (RA) patients. Methods Human FLS was transfected with p53siRNA and cocultured with CD4+ T lymphocytes from active RA patients. The expression of osteoprotegerin and IL-6 secretion was detected in the transfected FLS. In addition, the expressions of IFN-γ, IL-17, IL-4 and CD25 as well as mRNA levels of IFN-γ RORγt, IL-17 and Foxp3 in cocuhured CD4+ T lymphocytes were also measured. Results IL-6 secretion decreased in p53-inhibited FLS while osteopro-tegerin expression was not altered, p53-inhibited FLS could significantly increase IL-17 and IFN-γ expres-sions. It also upregulated Foxp3 expression though had no effect on CD4+CD25high T lymphocytes. Conclusion p53 expression in FLS regulates Th1 and Th17 cells of RA patients, and therefore participate in the pathogenesis of RA.

Hyperthrophic cranial pachymeningitis in Wegener granulomatosis: 3 case report and review of liter-atures / 中华风湿病学杂志

Objective To study the clinical, laboratory, radiological and pathological findings of patients with hypertrophic cranial pachymeningitis (HCP) in Wegner's granulomatosis (WG) to improve the recognition of the disease, even when it occurs in limited form. Methods Three patients were described and English literatures of biopsy-proven pachymeningitis in WG were reviewed. Results The features of WG-associated pachymeningitis included: ① Frequently occurred early in the course of active limited WG; ② Commonly presented with sever headache and cranial neuropathies in the absence of other meningeal irritative signs; ③ Variable cerebrospinal fluid findings with mild predominantly lymphocytic pleocytosis and elevated protein concentration were major laboratorg findings; ④Elevated ESR and positive serum anti-neutrophilic cytoplasmic antibody (ANCA) could be found in most patients; ⑤ Gadolinium-enhanced brain MRI is very senitive in the detection of pachymeningitis; ⑥A dural biopsy showed granulomatous necrotizing inflammation, giant cell, and evidence of vasculitis;⑦ A favorable response to standard treatment with corticosteroid, cyclophosphamide or other cytotoxic drugs could be observed. Conclusion HCP may be the initial or cardinal manifestation of the limited form of WG. Early diagnosis by ANCA, MRI and dural biopsy may facilitate diagnosis Corticosteroid and immunosupressant are the choices of treatment.

Relationship between IL-17 and autoimmune diseases / 基础医学与临床

IL-17 is the cytokine secreted by the subgroup of CD4+T cells named Th17.The differentiation,proliferation and cytokine secretion of Th17 are regulated by TGF-?,IL-6,IL-15 and IL-23.IL-17 modulates the production and secretion of proinflammative factors,CXCs,affecting the transfer of neutrophil,the activation and the absorption of bone.It suggests that IL-17 also plays an important role in the pathogenesis of autoimmune diseases.

Extraction and purification of Jo-1 antigen / 基础医学与临床

Objective To improve the purifying method of Jo-1 antigen from rabbit thymus used for detection of anti-Jo-1 antibody by dot-blotting immunoassay(DB).Methods The rabbit thymus glands were cut into pieces,homogenized and extracted by PBS.Total protein was precipitated by acetone to get acetone powder(RTAP).The RTAP was solved in PBS and separated by an by anti-Jo-1 IgG affinity column.Results 5～7 g RTAP was obtained from 100g rabbit thymus glands.There was 19%～24% of protein in RTAP.Jo-1 antigen was enriched around 1900 folds through affinity chromatography,with 2.5% recovery of antigenic activity.In this preparation,there were several bands on SDS-PAGE,but only one band about 50 ku,reacted with anti-Jo-1 antisera on immunoblotting.Dot-blotting also showed that the antigen only reacted with Jo-1 antisera.The purified Jo-1 antigen was not stable for long time,but the antigenic activity could maintain for a long time when there was MgCl2 in the solution.Conclusion Affinity chromatography was a simple and easy method for purifying Jo-1 antigen from rabbit thymus.The antigen purified by affinity chromatography could meet the requirement for detecting Jo-1 antibody bydot-blotting.

Analysis of changes in TCRBV and CDR3 diversity before and after auto-PBSCT for severe/refractory CTD / 基础医学与临床

Objective To study the changes of clonality of T cell receptor (TCR) and complementarity determinative region 3(CDR3) before and after autologous peripheral blood CD34+ stem cell transplantation(auto-PBSCT) for severe/refractory connective tissue disease(CTD). Methods Thirteen patients with severe/refractory CTD were enrolled for auto-PBSCT in Peking Union Medical College Hospital, including systemic lupus erythematosus (8 cases), rheumatoid arthritis(4 cases), and primary Sjogren’s Syndrome(1 case). Blood samples were collected before/after mobilization, 2 weeks, 1, 3, 6, 12 and 18 months post-transplantation. Diversity of TCRBV and CDR3 were showed by reverse transcription-polymerase chain reaction(RT-PCR) and genescan. Results The TCR BV usage and CDR3 spectral pattern of pre-auto-PBSCT CTD patients were revealed skewed pattern and oligoclonality, Which developed severe oligoclonality within 1 months after auto-PBSCT. However, they showed diversity andpoly-clonality 3～6 months after auto-PBSCT. Conclusion Skewed pattern and oligoclonality of TCRBV and CDR3 which implied auto-reactive were depressed after auto-PBSCT, and inclined to change to normal pattern.

Systemic lupus erythematosus patient with diffuse alveolar hemorrhage / 基础医学与临床

To present a case of systemic lupus erythematosus patient complicated by diffuse alveolar hemorrhage and severe immune deficiency. To improve the knowledgement of physicians about severe cases of SLE.

Treatment of rheumatoid arthritis by tumor necrosis factor inhibitor / 基础医学与临床

Tumor necrosis factor alpha(TNF-?) is one of the key proinflammatory factors in driving and attending chronic inflammatory process in rheumatoid arthritis(RA).TNF-? acts on different kinds of cell in synovial membrane,such as synoviocytes,macrophages,osteoclasts and chondrocytes,which can produce metalloproteinase,collagenase,stromelysin and so on,further induce pannus formation,joint inflammation,bone erosion and cartilage degradation. The TNF inhibitors have been proved by a lot of clinical trials to be an important new group of agents that significantly improve symptoms and signs,induce remission,reduce objectively measured damage in chronic inflammatory conditions,such as RA.There are three kinds of TNF inhibitors: Etanercept,Infliximab and Adalimumab.Etanercept is a fusion protein of human IgG and two p75 TNF receptors.Infliximab is an IgG1 monoclonal antibody(a chimera of human constant and mouse variable regions).Adalimumab is a humanized IgG1 monoclonal antibody with fully human constant and variable regions.The side effects include injection site infusion reactions,infection,lymphoproliferative disease,demyelinating disease,and SLE-like syndromes.

Thalidomide inhibits TGF-?1-induced transdifferentiation of human fetal lung fibroblast cell line to myofibroblast / 基础医学与临床

Objective To investigate the effects of Thalidomide(THD)on transdifferentiation of human fetal lung fibroblast(HFL-F) to myofibroblast(MF) induced by Transforming Growth Factor-?1(TGF-?1) and the effects on trans differentiated MF.Methods HFL-F to MF trans-differentiation was induced with 5 ?g/L TGF-?1.The effect of 50 ?g/L THD on HFL-F to MF transdifferentiation was evaluated by measuring hydroxyproline(HYP) content with alkaline hydrolysis colorimetry,?-smooth muscle actin(?-SMA) protein with Western Blot,?-SMA and collagen Ⅲ(COL Ⅲ) mRNA with semiquantitative RT-PCR.Results THD inhibited TGF-?1 induced up-regulation of HYP and COLⅢ mRNA expressions(all P0.05).For HFL-F treated with 5 ?g/L TGF-?1 for 96 h,THD inhibited COLⅢ mRNA expression(P

Clinical significance of antiendothelial cell antibody in systemic vasculitis and their autoantigens / 基础医学与临床

Objective To investigate the prevalence,their autoantigen and the clinical significants of antiendothelial cell antibodies(AECAs) in systemic vasculitis.Methods Western blotting was performed to detect specific AECA in serum of systemic vasculitis,SLE,RA,SS and healthy donors.Then to analyze the relationships of AECA with the disease manifestation.Results(1)The prevalence of AECA was 77.7% in systemic vasculitis,87.5% in SLE,66.7% in SS,7.14% in RA and 10% in normal group respectively.(2)AECA reacted with a heterogeneous series of endothelial proteins which ranged in molecular size from 16 to 120 ku Furthermore,AECA against a 47 ku endothelial cell antigen were more frequently found in a variety of systemic vasculitis and SLE.(3)Compared with those in AECA-negative patients,the mean levels of ESR in AECA-positive patients with TA and the mean levels of BVAS in patients with WG,MPA and CSS were both significantly higher in AECA-positive patients.Patients with BD who have AECA against 47 ku endothelial cell proteins were more frequently found to have neuropathy than those 47 ku-AECA-negative patients,and the prevalence of inhanced CRP are also more frequent.Conclusion AECA showed to be correlated with the disease manifestation,and the same molecular sizeantigen could be found in a variety of systemic vasculitis and SLE.

Regulatory T cells in patients with early new-onset systemic lupus erythematosus / 基础医学与临床

Objective To investigate the expression of FOXP3 and CD25 in CD4+ T cells of peripheral blood from patients with early new-onset systemic lupus erythematosus(SLE) before and after treatment.Methods Forty-four early new-onset SLE patients including twenty-four with active disease (SLEDAI≥10), twenty with low active disease (SLEDAI

BAFF and system lupus erythematosus / 基础医学与临床

BAFF is an essential ligand essential for survival and differentiation of peripheral B cells. By interacting with three receptors, BAFF can promote B cell maturation and class switching, enhance humoral immunity and T cell co-stimulation. Over-expression of BAFF leads to autoimmune diseases such as systemic lupus erythematosus (SLE) in mouse model. Treating the mice model with BAFF antagonists can slow-down disease progression and enhance survival rate. Moreover, in some SLE patients serum level of BAFF is elevated and correlated with serum anti-dsDNA titer. The preliminary clinical trial of anti-BAFF monoclonal antibody has shown to be safe and effective. BAFF antagonists are promising therapeutic drugs for SLE.

Effects of human cartilage glycoprotein 39 on the onset of rheumatoid arthritis / 中国组织工程研究

OBJECTIVE: One possible autoantigen-human cartilage glycoprotein 39(HC gp-39) becomes a hotspot in the researches on the morbidity and the therapy of rheumatoid arthritis(RA) by international rheumatologists in recent years. This exploration would investigate the source, structure, and biochemical significance of HC gp-39 and its effects in RA morbidity.DATA SOURCES: HC gp-39 related articles between January 1990 and January 2004 were searched by the computer on Medline with the searching word of "HC gp-39" and the language of the article was limited in English.STUDY SELECTION: Totally 100 English literatures related with HCgp-39 were selected.DATA EXTRACTION: Related literatures were extracted according to the latest progress of HC gp-39.DATA SYNTHESIS: Summery was summed up according to the source,structure and function of HC gp-39,and the relationship between HC gp-39and disease,especially the relationship between HC gp-39 and RA.CONCLUSION: HC gp-39 can be used as another measurable indicator except the traditional indicators for RA activity. The establishment of serological detection method has certain significance for RA early diagnosis,the judgment of the situation of RA,the improvement of prognosis and transformation. Antigen-specific immunotherapy can be considered.

Rheumatoid arthritis complicated by peripheral neuropathy: an analysis of lesion characteristics in 5 cases / 中国组织工程研究

BACKGROUND: Rheumatoid arthritis(RA) is a systemic disease mainly characterized by chronic and symmetric polyarthritis. Peripheral neuropathy due to RA, however, is uncommon.OBJECTIVE: To analyze the clinical manifestations and laboratory findings of RA complicated by peripheral neuropathy in 5 cases.DESIGN: A retrospective case analysis based on patients as subjects.SETTING: Department of Rheumatism and Immunity, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.PARTICIPANTS: Totally 567 RA patients were admitted to Peking Union Medical College Hospital from January 1983 to December 2002, including 5 cases of peripheral neuropathy. All the cases met the criteria for RA formulated by American Rheumatism Association(ARA), according to which 5 cases of peripheral neuropathy in the active phase were confirmed due to RA. The laboratory indexes in 5 cases accorded with the active core indexes of RA.METHODS: Clinical data of 5 cases of RA were analyzed, and symptoms of peripheral neuropathy, as well as the indexes recorded electrophysiologically and in laboratory were recorded and assessed MAIN OUTCOME MEASURES: Sex, age, course of disease, severity of muscle strength disorder and sensory disorder, electromyography(EMG),biopsy of muscle and nerve, and related laboratory indexes.RESULTS: Five cases were enrolled, including 2 males and 3 females, 42 to 60 years of age(meanly 52 years old), and the course of disease ranged 1 to 14 years, and 5.4 years on the average. Four cases were hospitalized for neurological manifestations, accounting for 80% (4/5), and the other one appeared to have decreased muscle strength and hypoalgesia. Asthenia and numbness of limbs and hypoalgesia of the distal of limbs occurred in 4 cases,paraesthesia in 3 cases, foot drop in 2 cases, carpoptosis in 1 case, myatrophy in 3 cases, decreased muscle strength in 5 cases, and tendon areflexia in 3 cases; joint swelling or pain during the appearance and aggravation of peripheral neuropathy in 4 cases, increased erythrocyte sedimentation, increased level of C-reactive protein, high-titer rheumatoid factor and X-ray changes of joints( i. e., narrowed joint space or erosion and destruction on surface of joint) in 5 cases There were 3 cases complicated by vasculitis, and 2 cases by rheumatoid nodules. EMG showed damages of peripheral nerves in 4 cases. Muscle biopsy and nerve biopsy exhibited neurogenic lesion and chronic moderate axonal neuropathy respectively in 1 case.CONCLUSION: In the present study, the incidence of peripheral polyneuropathy was 1% (5/569), which mainly occurred or was aggravated in the active phase of RA. Among the 5 cases of peripheral neuropathy, 100% (5/5 )developed decreased muscle strength, 60% (3/5) developed myatrophy and 80% (4/5) had symptoms of peripheral neuropathy. The findings are helpful in the early diagnosis of RA.