J Rheumatol:幼年特发性关节炎中胃肠驱动全身炎症的血清学证据

2017-10-25 xiangting MedSci原创

有证据表明多关节型JIA、少关节型JIA和SpA儿童对肠道细菌产物的暴露增加。

越来越多的证据将幼年特发性关节炎(JIA)与肠道微生物等非宿主因素联系起来。研究人员假设新发JIA儿童肠道细菌易位和循环脂多糖(LPS)有所增加。

对初治JIA患者进行了研究(多关节型JIA,n = 22,少关节型JIA,n = 31,和脊柱关节炎(SpA),n = 16],确诊为炎症性肠病相关性关节炎的患者(IBD-RA,n = 11),和34例健康对照。确定了来自这些患者和健康对照的血浆或血清中的循环性IgG反应性/LPS,LPS结合蛋白(LBP),α-1酸性糖蛋白(α-1AGP)和C反应蛋白(CRP)。计算JIA患者的幼年关节炎疾病活动评分(JADAS-27)。

多关节型JIA(p = 0.001),少关节型JIA(p = 0.024)和SpA(p = 0.001)患者的循环性抗核LPS抗体浓度显著高于对照组,组间无显著统计学差异。与对照组相比,多关节型JIA(p = 0.001),少关节型JIA(p = 0.002)和SpA(p = 0.006)患者的循环性LBP显著升高,α-1AGP浓度也是如此(p = 0.001,0.001和0.003)。在任何测定中对照组和IBD-RA患者之间没有差异。LBP和α-1AGP的循环浓度与CRP浓度强相关(分别为r=0.78和r=0.66)。抗核LPS抗体水平和CRP(r = 0.26),LBP(r = 0.24)和α-AGP(r = 0.22)浓度相关性较弱。JADAS-27评分与LBP(r = 0.66)和α-1AGP浓度(r = 0.58)相关。

有证据表明多关节型JIA、少关节型JIA和SpA儿童对肠道细菌产物的暴露增加。这些数据强化了肠道是JIA免疫刺激源的概念。

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    2017-10-27 lmm397
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