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Journal of Peking University(Health Sciences) ›› 2018, Vol. 50 ›› Issue (6): 975-980. doi: 10.19723/j.issn.1671-167X.2018.06.006

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Clinical significance of detection of soluble interleukin 2 receptor alpha chain in the assessment of rheumatoid arthritis disease activity

Jia jia XU1,Yan WANG1,△(),He SUN1,Ru lin JIA2,Xue wu ZHANG1,△(),Yang MENG1,Li li REN1,Xiao lin SUN2   

  1. 1. Department of Rheumatology and Immunology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
    2. Department of Rheumatology and Immunology,Peking University People’s Hospital,Beijing 100044, China
  • Received:2018-07-10 Online:2018-12-18 Published:2018-12-18
  • Contact: Yan WANG,Xue wu ZHANG E-mail:wangyanh_1963@163.com;xuewu@sohu.com
  • Supported by:
    Supported by the National Natural Science Foundation of China(81471601)

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Abstract:

Objective: To evaluate soluble interleukin-2 receptor alpha chain (sIL-2Rα, sCD25) in serum for the determination of rheumatoid arthritis (RA) activity.Methods:Peripheral blood was collected from 108 patients with RA, 39 patients with osteoarthritis (OA) and 50 healthy control subjects, and synovial fluids were from 40 patients with RA. The sera from the patients with RA, the disease control group (osteoarthritis), the healthy control group, and the synovial fluids of the RA patients were detected by enzyme-linked immunosorbent assay (ELISA).The clinical manifestations and laboratory parameters of the patients with RA were recorded and the correlation with the serum sCD25 level was analyzed.Results:The serum sCD25 concentration in RA group was (2 886±1 333) ng/L, the serum sCD25 concentration in OA group was (2 090±718) ng/L, and the serum sCD25 concentration in healthy group was (1 768±753) ng/L. The serum sCD25 level in the patients with RA was significantly higher than that in the disease controls and healthy controls (P<0.001). Sensitivity of serum sCD25 in the diagnosis of RA was 66.1% and specificity was 83.0%;serum sCD25 levels and erythrocyte sedimentation rate (r = 0.321, P = 0.001), C-reactive protein (r=0.446, P<0.001), DAS28 score (r = 0.324, P<0.001), joint tenderness count (r=0.203, P=0.024), D-dimer levels (r=0.383, P<0.001), age (r=0.24, P=0.007), IgG (r=0.207, P=0.028), HRF-IgG (r=0.345, P=0.034) showed a significant positive correlation, and disease duration (r=-0.206, P=0.021) showed a negative correlation with sCD25;In patients with rheumatoid arthritis, the positive rates of serum ESR, CRP, and sCD25 were 14.3% (2 cases), 14.3% (2 cases), and 71.4% (10 cases) in the low disease activity group. The positive rates of serum ESR, CRP and sCD25 in the moderate disease activity group were 94.2% (49 cases), 82.7% (43 cases), and 86.5% (45 cases). The positive rates of serum ESR, CRP, and sCD25 in the high disease activity group were 100% (42 cases), 95.2% (40 cases), and 90.5% (38 cases);36 cases of ESR and/or CRP were negative (about 33.3%) in 108 patients, serum sCD5 levels of 17 cases in these 36 cases (about 47.2%)increased, of which 14 cases (about 82.4%) had a DAS28 score higher than 3.2.Conclusion:The serum sCD25 has a high specificity for diagnosis of RA and a poor sensitivity. The serum level is closely related to the activity of RA, indicating that sCD25 may be involved in the inflammatory process of RA and may become a new inflammatory marker of RA.It is more meaningful for detection of serum sCD25 when RA is active, but ESR and/or CRP is negative.

Key words: Rheumatoid arthritis,activity, Interleukin 2 receptor α chain;, Sera sCD25, Erythrocyte sedimentation rate, C-reactive protein

CLC Number: 

  • R593.22

Figure 1

Analysis of sCD25 level in serum of patients with RA/OA and healthy human and joint fluid in partial patients with RAA, comparison of serum sCD25 levels in 108 patients with RA, 39 patients with OA, and 50 healthy individuals; B, comparison of sCD25 levels in serum of 108 patients with RA and 40 cases of RA joint fluid; C, comparison of sCD25 levels in serum of 10 RA patients and their joint effusion in the same period; RA, rheumatoid arthritis; OA, osteoarthritis; HC, healthy control; SF, joint effusion."

Table 1

Correlation between serum sCD25 levels and laboratory parameters in patients with RA"

Characteristics sCD25 in peripheral blood/(ng/L)
r P
Age/years 0.24 0.007*
Duration/years -0.206 0.021*
Tender joints, n 0.203 0.024*
Swollen joints, n 0.156 0.083
RF/(IU/mL) 0.110 0.248
ESR/(mm/h) 0.321 0.001*
CRP/(mg/L) 0.446 <0.001*
ACPA/(IU/mL) 0.043 0.659
RF-IgG/(IU/mL) 0.345 0.034*
GPI/(mg/L) 0.127 0.375
IgG/(g/L) 0.207 0.028*
IgA/(g/L) 0.159 0.092
IgM/(g/L) 0.069 0.467
C3/(g/L) 0.083 0.384
C4/(g/L) 0.059 0.537
ASO/(IU/mL) 0.048 0.614
D-dimer/(mg/L) 0.383 <0.001*
WBC/(×109/L) 0.214 0.017*
Neu/% 0.262 0.003*
DAS28 0.324 <0.001*

Table 2

Distribution of DAS28, ESR, CRP, and sCD25 in the low, medium, high disease activity groups (x-±s )"

Items LDA(n=14) MDA(n=52) HDA(n=42)
DAS28 3.11±0.05 4.46±0.51 5.67±0.32
ESR/(mm/h)* 12.50±5.58 32.62±23.18 62.19±28.45
CRP/(mg/L)* 17.00±2.05 19.65±25.16 50.26±38.16
sCD25/(ng/L)* 2 592±1 380 2 904±1 821 3 351±1 974

Figure 2

Comparison of ESR/CRP/SCD25 positive rates in disease activityA, LDA; B, MDA; C, HDA; LDA, low disease activity; MDA, moderate disease activity; HDA, high disease activity."

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