【摘要】 目的 :探讨MTX治疗类风湿性关节炎 (RA)的免疫学机制 ,为临床MTX治疗RA提供理论依据。方法 :在建立佐剂型关节炎 (AA)动物模型基础上 ,通过关节炎指数评价 ,血清中细胞因子测定和关节切片的病理学检查 ,观察MTX对促炎症细胞因子如IL 1β、TNF α和抗炎症细胞因子IL 4、IL 10的调控作用。 结果 :MTX预防组和对照组关节炎指数和发病率的变化均无显著差异 (P >0 .0 5 )。MTX肌肉注射治疗或外用治疗后 ,关节炎指数发生较显著的变化与对照组相比有显著性差异 (P<0 .0 5 )。对照组与MTX预防组、MTX肌肉注射组、MTX外用组血清中细胞因子水平相比 ,对照组与各组TNF α和IL 10的水平有明显差异 ,P <0 .0 5 ,MTX肌肉注射组与MTX外用组的TNF α水平相差很大 ,P <0 .0 5。而IL 1β、IL 4的水平各组之间没有明显差异 ,P >0 .0 5。病理组织学变化中炎症程度 :对照组 >MTX预防组 >MTX肌肉注射组 >MTX外用组。结论 :本研究结果表明 ,MTX治疗 (肌肉注射和外用 )可以降低AA大鼠血清中TNF α浓度 ,提高IL 10的浓度 ,从而抑制或控制RA的发生发展。但MTX治疗对IL 1β和IL 4没有明显作用 ,这方面的机制尚需进一步研究。更多还原

【Abstract】 OBJECTIVE:In this study , we will explore the immune mechanism of treatment rheumatoid arthritis with methotrexate and provide the experimental basis for clinical therapy. METHOD:We established an experimental adjuvant arthritis, arthritis assessment ,serum cytokine measurement and histologic analyses were performed ,observe MTX regulative effect on proinflammation cytokine such as IL 1β,TNF α and anti inflammation cytokine such as IL 4 and IL 10. RESULTS:arthritis assessment and the incidence of the arthritis in Rats treated with MTX was comparable with that in controls. Rats treated with MTX(muscle injection or exteral use MTX) had a significantly lower arthritis assessment compared with untreated control.The result showed that the level of TNF αand IL 10 in control group was significantly lower than these groups of that MTX prevention ?MTX treatment(muscle injection and exteral use) ( P <0.05). The level of TNF α in MTX muscle injection group has a significantly lower compared with that in MTX exteral use group( P <0.05). There was no significant difference between MTX treatment group and control group in the level of IL 1βand IL 4 ( P >0.05). The severity of inflammation is control>MTX prevention >MTX muscle injection > MTX exteral use in the change of histologic finding.CONCLUSION:This study showed that MTX treatment (muscle injection and exteral use )can reduce the concentration of TNF α and increase the concentration of IL 10 in serum of AA rats,and inhibit or control occurrence and progress of RA .But MTX treatment had no significant influence on the level of IL 1β and IL 4 , the mechanism should be further studied.更多还原